Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

Neurosurgery mainly deals with treating of functional disorders that affect the nerves, brain and muscles through major or minor surgery. The field of neurosurgery makes use of advanced surgical procedures. The different techniques are used to treat brain tumors, trauma to the head, cerebral hemorrhages, spinal disc herniation, brain aneurysms and peripheral neuropathy.

Neurosurgery Treatment
The main aim of neurosurgery treatment in patients suffering from stoke is to prevent neurologic deterioration as well as the recurrence of stroke. The advancement in medical treatment has increased to a great extent, however the mortality and morbidity in stroke patients is very high. The second leading cause of death all over the world is stroke, and hence, through neurosurgery stroke can be managed. Each year in the U.S there are about 800,000 people who suffer from stroke which causes disability.

Symptoms of Stroke and its Effects
The main symptoms of stroke are not identified easily by people. However, the symptoms that are caused on delay of treatment include difficulty in speaking, weakness on one side of the body, drooping on one side of the face and difficulty in walking.

Stroke at times is life threatening and it is also referred to as brain attack and can occur at any time to an individual. It is caused when the flow of blood supply to the brain is cut off and oxygen is deprived to the brain cells. Brain dysfunction occurs due to the dead brain cells and hence some patients lose their memory and control over their muscle movement. The treatment of stroke in such cases includes a neurosurgery by a neurological specialist.

Types of Stroke
The abrupt interruption to the flow of blood that causes hindrance in the neurological function can be best treated if detected early and by accurate diagnosis by a neurosurgeon. There are 3 different types of stroke that can occur and these include Hemorrhagic stroke, Ischemic stroke and Transient ischemic attack. The Ischemic stroke mainly occurs when blood vessels that supply blood to the brain are blocked. It is a common form of stroke and its underlying cause is known as atherosclerosis. The main procedures that are used for treating ischemic stroke include tissue plasminogen activator and endovascular procedure.

In the tissue plasminogen activator procedure, the patient is given medicine intravenously. The blood flow to the affected area of the brain is improved when the blood clot dissolves through this method. The medication is given immediately after 3-4 hours on occurrence of the stroke symptoms. In the second procedure, a catheter is used, which is injected in the area of the obstructed blood vessel. The blood flow to the area is restored by the endovascular procedure. Even anticoagulants are given to thin the blood and prevent clogging.

Neurosurgery In Management Of Stroke!

For a long time cholesterol in totality was seen as a bad thing for your body although the truth was a little more complicated than that. Cholesterol primarily is divided into two types, one of which can be categorized as bad cholesterol and the other as good cholesterol. Let's have an in-depth look at both the categories.

Ldl or low density lipoprotein aka bad cholesterol: cholesterol is a wax like chemical which is found all over the body and it has important functions to perform. Cholesterol is carried all over the body by lipoproteins. The low density lipoproteins are denoted as bad cholesterol as they can accumulate on the walls of the blood vessels and cause blockages resulting in many ailments. Ldl levels of 190 and above are considered dangerous. 

Some of the risks associated with it are:
1. Heart disease
2. Stroke
3. Atherosclerosis
4. Peripheral artery disease among many others

Hdl or high density lipoprotein aka good cholesterol - this is a form of cholesterol which is usually desired in higher quantities as it removes ldl from the system by dislodging it from the arteries and then carrying it through the bloodstream into the liver. The liver then breaks it down and removes it from the body. Thus, higher number of hdl cholesterol is always desirable. Some of the ideal numbers for hdl cholesterol within the body are:

For women - ideal: 60 mg/dl, dangerous: 50 mg/dl or lower
For men - ideal: 60 mg/dl, dangerous: 50 mg/dl lower

The role of triglycerides
Good and bad cholesterol levels also depend on the levels of triglycerides within the body and not just ldl or hdl cholesterol. Triglycerides are another type of fat which are used to store energy within the body, but can also affect your health. It is most associated with atherosclerosis when the levels of triglycerides are high within the body. 

Some habits that contribute to high levels of it are
A. Lack of physical activity
B. Obesity or being overweight
C. Excesses in alcohol consumption
D. Smoking
E. Bad diet and others

Thus the good cholesterol vs bad cholesterol war also includes other factors, most of which can be easily changed by making subtle changes in lifestyle and incorporating healthier habits. This will increase the good cholesterol and the other relevant elements and reduce the bad.

Good Cholesterol Vs Bad Cholesterol

Cholesterol is a vital component, which helps the body to make healthy cells. This wax like component is found in the lipid of the blood. An increased cholesterol count elevates the risk of heart diseases in a person. It thickens the vessels of the arteries resulting in less oxygen flow in the heart. This, in turn, increases the chances of a stroke. High cholesterol can happen from lifestyle habits and inheritance. It is completely treatable and preventable.

What causes high cholesterol?
The blood carries the cholesterol which is attached to the proteins. The combination of cholesterol and protein is known as the lipoprotein. Primarily there are two different kinds of cholesterol that the lipoprotein carries:

    Low-density lipoprotein: LDL is the bad guy that carries all kinds of cholesterol present in the body. It eventually rests on the walls of the arteries, making it narrow and hard.
    High-density lipoprotein: This is the good guy which scans the excess cholesterol and take them back to the liver.

Ideally, the body should have low LDL and high HDL. But often the reverse happens, resulting in high cholesterol and cardiac diseases. Factors such as unhealthy diet, inactivity for most of the day and obesity is responsible for the same. Even the genetic set up can play a hand in a high count of LDL in the body. There is nothing that can be done in this case except to seek medical help.

6 factors that put you at risk:

    Poor diet: Cholesterol levels are dramatically increased when baked products and saturated fats are consumed in an excess amount. Other high cholesterol food products include dairy products, processed fats and red meat. Refraining from this food items will drastically reduce the chances of getting high cholesterol in the body.
    Obesity: Obesity results from too much of fat storage in the body. It not only fatigues a person faster, but puts a person at high risk of getting cholesterol. The body mass index should be always lesser than 30 to abstain the risk of cholesterol.
    Waist circumference: A waist circumference of more than 40 inches in men and 35 inches in women can increase the risk of cholesterol.
    Diabetes: This is one of the major causes of high cholesterol. It not only damages the artery lining, but results in higher LDL and lower HDL.
    Less workout: Leading a life which is devoid of exercise and jogging can increase the chances of getting high cholesterol. Exercise boost HDL count in the body and mitigates the risk of low HDL.
    Smoking: The blood vessel walls get damaged with smoking. The blood vessels start accumulating fatty acids thereby increasing the chances of getting high cholesterol.

What Causes High Cholesterol? 6 Factors That Put You at Risk

In our bodies, the vascular system is composed of vessels. This system is comprised of a complex network of veins and arteries. The arteries transport oxygenated blood away from the heart and spread it throughout our bodies and veins brings the deoxygenated blood (oxygen-poor) back to the heart for purification. Whenever this complicated process gets disturbed, pain, dysfunction of the system, and other complications may occur.

Most common complications among all are:
1. Abdominal Aortic Aneurysm: This condition is when there is a  bulge  formed in the weak area of the largest artery in the abdomen and keeps on increasing with each pressure flow of blood from that artery. This condition weakens the artery further and massive internal bleeding may occur.

2. Carotid Artery Disease - Stroke: This condition arises when the main blood vessels flowing blood to the brain develops a plague caused due to hardening of the arteries (atherosclerosis). The continuous increase of plague can cause a stroke.

3. Peripheral Arterial Disease: This condition occurs when the flow of oxygen-rich blood is insufficient to the lower limbs of the body due to hardening of the arteries in that area. This can cause difficulty in walking, foot ulcers, infections and can even lead to amputation.

The complication of these types are corrected by the vascular surgeon with the process is commonly known as vascular surgery. However, this condition is sometimes medically managed by an innovative, less invasive procedure called Endovascular surgery. 

Vascular Surgery-
Vascular surgery is generally the traditional surgery that corrects the diseases outside of the heart and the brain. This procedure is more invasive as it involves incisions that are surgical in nature. Vascular surgery comprises of the surgery of the aorta, carotid arteries, and other small diametric arteries. This surgery also involves surgery of veins for treating various conditions such as varicose veins and May-Thurner syndrome.

Endovascular Surgery:
However, this type of surgery is an innovative way to treat medical conditions related to the vascular system. For instance, during the procedure of treating the Abdominal Aortic Aneurysm, it involves making a small cut near the hip area and inserting the endovascular graft through the arteries and is positioned inside the aorta, in a catheter, which is a flexible, long, and narrow tube. The endovascular graft is a tube device made up of special fiber and is framed within stainless steel self-expanding stents. The grafts expand and seal off the aneurysm. This stops the internal bleeding the system and the graft remain in the aorta permanently.

This method has a short recovery time, smaller incisions, less discomfort, less stress on the heart and has fewer risks. This surgery is appropriate for the patient who is at high
risk of complications. 

Take Away-
Diseases related to artery and veins are now being treated with various methods such as angiography, stenting, sclerotherapy in various countries. These days vascular surgeons have become proficient with the endovascular surgical methods. Endovascular surgery is durable and less painful and stressful when viewed with the context of vascular surgery. However, the cost of staying longer at the hospitals is somewhat got balanced by the high cost of imaging equipment and other high financial expenses in the endovascular surgery.

Endovascular VS Vascular Surgery - Know The Difference!

High cholesterol has become a very common phrase nowadays. With excessive consumption of fast foods and sugar, lifestyle disorders such as diabetes and high cholesterol have become very common. In order to know what high cholesterol is, you should first know about cholesterol.

Cholesterol is a type of fat present in the body which is needed for regulating hormones in the body. It also plays an important role in Vitamin D production. Though you get cholesterol from food, the body has its own supply of cholesterol as well. Excessive cholesterol in the body can lead to cholesterol build up in your arteries, resulting in blood circulation problems. The arteries tend to narrow down, not allowing the blood to flow properly. High cholesterol levels are linked to heart problems and strokes.

Ayurveda is a holistic system of medicine, the treatments of which are based on natural ingredients. It is very effective and free from side effects, unlike conventional methods of treatment. Ayurvedic remedies for high cholesterol levels in the body aim to bring down the cholesterol level and improve your overall wellbeing.

The Ayurvedic tips to lower cholesterol levels are:

Eat healthy: Diet plays an important role in maintaining healthy cholesterol levels, so eating healthy is of paramount importance. Include plenty of vegetables and fruits in your diet to get the required amount of Vitamins and minerals in order to keep your body healthy. Avoid refined grains as they spike your blood sugar levels. Instead opt for whole grains such as brown rice.
Eat healthy fats: Eat healthy fats such as unsaturated fats present in foods such as almonds and olive oil. Keep saturated and trans-fats at bay as they increase cholesterol levels in the body.
Exercise regularly: Regular exercise keeps your weight levels optimal and also brings down your cholesterol levels. Simple cardiovascular exercises such as running and swimming can be done on a regular basis.
Avoid smoking: Smoking causes your blood vessels to constrict, thus hampering the flow of blood. In addition to accumulation of plaque, this can further hamper blood flow.
Maintain optimal weight levels: Following healthy eating habits along with regular exercise will allow you to maintain optimal weight levels. So if your weight is on the higher side, then re-evaluate your eating habits and make the necessary changes. If you wish to discuss about any specific problem, you can consult an Ayurveda.

Cholesterol Level - Ayurvedic Remedies That Can Lower It!

Don't wait any longer, manage your Cardiologist online with a Lybrate doctor today

Consult for Cardiologist - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES