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?

Peripheral vascular disease (PVD) is a circulation issue that affects the veins and blood vessels outside of the brain and heart. PVD commonly strikes the veins that supply blood to the arms, legs, and organs situated beneath the stomach. These are the veins that are located away from the heart. They are known as peripheral vessels.

In PVD, the width of the veins get limited. Narrowing is normally created by arteriosclerosis. Arteriosclerosis is a condition where plaque develops inside a vessel. It is additionally called 'solidifying of the arteries'. Plaque acts towards reducing the amount of blood and oxygen that is supplied to the arms and legs. As the plaque development advances, clumps may develop, which may further affect the vessel.

There are two main types of PVDs:

    Functional PVD: This doesn't include physical issues in the veins. It causes accidental side effects. Typically,these fits happen suddenly.
    Organic PVD: This includes changes in the vein structure. This sort of PVD causes irritation, tissue harm, and blockages.

The most well-known reasons for functional PVDs are as follows:

    Emotional stress
    Smoking
    Cold temperatures
    Operating Vibrating machinery

The common causes of such natural PVDs are given below:

    Smoking
    High circulatory strain
    Diabetes
    High cholesterol

The symptoms include the following:

    Cramps
    Achiness
    Fatigue
    Burning

Diagnosis:

PVD can be diagnosed using interventional radiology (IR).

IRis a sub-claim of radiology that gives an image-guided diagnosis, and if required, includes treatment of the organs as well.It has developed as a first-line treatment in the administration of PVD.

Advantages:

IR medications are for the most part less demanding for patients than surgery, since they include no surgical cut.They are less painful and have shorter stays at the hospital. By and large, the patients are discharged on the same day the procedure is done. This mainly includes angioplasty and stenting. The procedure is as follows:

    Utilising imaging for direction, the interventional radiologist puts a catheter through the femoral artery in the crotch to the blocked vein in the legs.
    At that point, the interventional radiologist expands a balloon to open the vein that is blocked.
    Sometimes it is opened with a tiny metallic cylinder called astent.
    This is a treatment that does not require surgery; only a scratch in the skin the extent of a pencil tip.

Alternative measure:

Angioplasty and stenting have totally replaced invasive surgical methods. Early trials have proven IR to be as successful as surgery for some blood vessel and artery impairments. Earlier, extensive clinical experience demonstrated that stenting and angioplasty are favoured as first-line treatments for more procedures all through the body .

Doctors as well as patients who have been through the same, believe that IR is much better for PVD than invasive surgery, since it reduces the risk of infection.

Diagnosing Peripheral Vascular Diseases With Interventional Radiology

The heart is a muscular organ that functions like a pump by moving blood through a fine, interconnected network of blood vessels. One set of blood vessels collect oxygen-rich blood from various parts of the body and gets it to the heart. It is then sent to all parts of the body through another separate channel of vessels.

The blood also transports various nutrients to the different body parts. Fat molecules or cholesterol is one of them. In fact, with changing diet patterns, there are more of fat molecules. They are heavier than the other particles, and so tend to settle down along the walls. This is known as plaque formation. This attracts more fat molecules to settle down and gradually forms a larger mass of fat cells. It also reduces the diameter of the vessel, thereby lowering the amount of blood that reaches the target organs.

Another effect it has is that it encourages the heart to exert extra pressure to push the blood through the vessels. There are simple ways to reduce blood pressure (BP), and some of these are listed below.

Eat healthy: Avoid processed and/or packaged foods. Increase the intake of fresh foods with lots of grains, vegetables, fruits, and dairy products. Include antioxidants like flaxseed, olive oil and omega-3 fatty acids to improve heart health. Avoid foods rich in calcium, sodium and magnesium. Increase consumption of potassium, which is good for heart.
Exercise regularly: Exercising has multiple benefits, and one of them is to improve heart health. It improves circulation, keeps the heart muscles active and strong and helps them pump blood better throughout the body.
Quit smoking: Smoking has severe effects on the overall health of an individual and heart health in particular. So quitting smoking can be hugely beneficial for the heart. It reduces the rate of plaque build-up and also helps in reversal.
Practise weight management: An increasing waistline is definitely not good for your heart, so watch your weight and keep your body mass index (BMI) in check. Watch what you eat, work out, and get your weight under control.
Follow stress management: The effect that stress has on our health cannot be underrated. Be it yoga, music, meditation, exercise or spending time with family/friends, choose what works best for you and learn to relax and manage stress.
Reduce alcohol consumption: More than two drinks per day can increase blood pressure significantly. So if you can t control, just quit.
Increased blood pressure is more rampant than what it was a few decades back. The age of onset is also reduced, with people in 30s now having hypertension. Making the above lifestyle changes can help lower your BP. Lifestyle diseases are now starting early in child hood. It is important to allow them to eat healthy food and physical activity. Smoking etc starts in school and need to be prohibited.

6 Simple Things That Can Help Lower Your Blood Pressure

Yoga is a spiritual practice combined with both mental and physical disciplines which for the first time emerged on Indian soil and later split into various schools but the actual fragrance of yoga remained same throughout the time. Nowadays, with increasing studies and researchers on various pre-Vedic traditions put an entirely new light on the practice of Yoga. While until now it has mainly been considered as a spiritual practice, a new study from Indianapolis University claims that yoga is a kind of practice which is not only limited to psychological phenomena rather the practice of yoga enables one to withstand the effects of stroke.

After You Survived Of A Stroke: In most of the cases, strokes finally lead to prolonged disabilities. It is due to the fact that a stroke takes place when a part of a brain fails to get a steady supply of Blood rich in Oxygen. Apart from this blockage in a vessel may hamper the blood supply in the brain. Similarly, the after effect of a stroke entirely depends on which part of the brain is affected. So a stroke may cause dysfunction of normal speech or steady movement of arms and legs. It is why after a stroke one has taken recourse to rehabilitation with the aim of resolving life-long disabilities. The rehabilitation process includes certain exercises basically opting for movements and physiotherapy. Sometimes the effort of therapists bears fruit and sometimes all goes in vain
Yoga As A Healing Power: The new research from Indianapolis has voiced in favour of adding yoga to stroke rehabilitation because it consists of poses, breathing and meditation. In this study, forty-seven male stroke survivours were divided into two groups and between these two groups, one attended yoga session for eight weeks. After eight weeks it has been seen that those who attended yoga session has successfully completed the rehabilitation session in a comparatively shorter period.
Practice Of Yoga Increases Your Chance To Recover Soon: According to the researchers, the added advantage of yoga is that besides improving balance it improves the quality of life and reduce the fear of falling. If you or any of your family members has survived of a stroke, yoga is not the first step you would be advised to take recourse to rather the researchers say that at first begin the rehabilitation programme but add the practice of yoga with it. But before you add yoga to your checklist, you should consult it with your doctor whether the yoga would suit or not.
Yoga Develops A Style Of Life: In conclusion, it can be said that recovering from a stroke is actually to prevent the second attack. So you need to ensure a proper lifestyle without those addictions like smoking and drinking which are harmful to you. Afterall yoga develops an upliftment in thinking which would further help you to maintain a healthy life.

The Healing Power Of Yoga After A Stroke!

There are two primary factors that are more likely to cause a stroke in a person i.e age and a family history. While both are inevitable, this necessarily doesn t have to be the fate of a person. Brain stroke is entirely preventable as with the case of other diseases. By working on the potential health risk factors, a stroke can be prevented. Here is a list of few such steps which, when followed can pay rich dividends to a person facing the risk of a brain stroke:

Blood Pressure: Blood pressure is the single most important factor that can increase the chance of a brain stroke. If a perfect blood pressure reading seems too difficult to achieve, a more realistic blood pressure target of 140/190 should be aimed for. Some of the common steps in order to achieve an acceptable blood pressure figure include reducing salt in the diet, exercising on a daily basis, regular intake of fresh fruits & vegetables and fast processed food containing processed fats. Finally, quitting drinking and smoking goes a long way in ensuring that a person is safe from strokes.

Losing Weight: Obesity increases the risk of diabetes and blood pressure subsequently increasing the risk of a stroke. Being overweight, therefore greatly increases the odds of a stroke. A BMI of 25 should be maintained by engaging in activities such as walking, running and playing on a daily basis.

Regular Exercise: Exercise is a clear mandate for people facing an increased risk of brain strokes. A moderate intensity exercise schedule for a minimum of 5 days per week is necessary. Some simple steps in order to achieve this include taking the stairs while climbing, joining a fitness club, 30 minutes of daily walk in a day etc.

Moderate Drink: Surprising as it may sound, moderate drinking on a daily basis can dramatically reduce the risk of a brain stroke. Red wine should be the choice of preference in this case. It should be ensured that the level of drinking does not surpass more than a glass. Regular drinking in excessive quantity can increase the chance of brain stroke.

Check For Atrial Fibrillation: This is a disease that is related to the heart due to an irregular heartbeat. There is a possibility of the clots travelling to the brain causing a brain stroke. Certain possible symptoms of this disease such as palpitation of heart and shortness of breath should be checked with a doctor to negate the chance of brain stroke. Certain blood thinners like warfarin and aspirin can shield against atrial fibrillation. A doctor has to be consulted before starting any medication related to the heart.

Top Ways To Prevent A Brain Stroke

The CAD (Coronary Artery Disease) is a condition where the blood flow in your arteries is impaired. This happens when the blood vessels that supply blood to your heart are damaged. As a result, plaque builds up in the arteries and the blood flow to the heart is decreased.

This will eventually lead to chest pain or angina and other symptoms. If the arteries are blocked completely, you may suffer a heart attack later on. It is one of the leading causes of death and heart attacks all over the world.

What are the causes of CAD?

The CAD may be caused due to an injury to the inner part of the coronary artery. This may be due to the following factors  

High blood pressure and cholesterol

Smoking

An unhealthy or sedentary lifestyle

Diabetes

If the inner wall of the artery is damaged, deposits made of cholesterol and other cellular wastes are collected in the region. The process is called atherosclerosis. If this plaque surface breaks, the platelets in your blood will try to fix the artery. In the process, these platelets are accumulated in the area. Too much accumulation can block the artery.

As the arteries are responsible for providing oxygen-rich blood to your heart, blockage in the region will lead to a heart attack.

Moreover, Coronary Artery Disease may be caused if you have a family history of heart diseases. It is more likely to occur when you are over 65 years of age. Factors such as obesity and high levels of stress can also lead to this condition. 

Symptoms

The common symptom of Coronary Artery Disease is angina or pain in the chest. However, the condition may be accompanied by other symptoms, like  

Tightness, heaviness, burning or a squeezing sensation in the chest

Sweating

Dizziness

Shortness of breath followed by extreme fatigue

Pain in the arms, shoulders or the back

Severe pressure in the shoulders and arms that lead to heart attack

The angina symptoms are commonly misunderstood as symptoms of indigestion. Be aware and seek medical assistance immediately.

Treating CAD with Ayurveda 

The following Ayurvedic herbs are helpful for preventing the deposits of harmful fats in your blood vessels  

Guggulu

Chandraprabha Vati

Combination of herbs like Amlaki, Arjuna, Punarnava, Kutki and Triphala

Another important treatment procedure for the disease, as prescribed by Ayurveda, is meditation. Meditating for about 20 minutes every day will help you relax and calm your nerves. It will help you enhance your mental health and happiness. This will keep your heart healthy.

This prevents the body from forming angiotensin is a hormone that causes your blood vessels to get smaller which increases your blood pressure. This baeltablet helps in Lower angiotensin levels, then help widen your blood vessels and let your blood flow more easily this reduces your blood pressure. This Bell tablet helps in blocking the effects of angiotensin on your heart which helps in lowering your blood pressure and these roots helps in preventing blood clots from forming, some do this from making substances called clotting factors and others keep the clotting factors from working or preventing other chemicals from forming so that clots cannot develop. What is most important is that all these herbs help in dissolving existing plaque. This drug also works as thromboxane it prevents platelet to stick together to form a clot.

You can also opt for Panchkarma therapy that is a rejuvenating experience consisting of massages and steam baths. High cholesterol is effectively treated using this therapy. 

To prevent risks of CAD, you must exercise regularly and avoid consuming foods high in fats and sugar. Reduce the amount of preserved foods. Eat more fresh fruits and vegetable daily. Furthermore, get plenty of sleep and stop consuming alcohol or cigarettes to stay healthy.

CAD (Blockage In Arteries) - How Can Ayurveda Handle It?

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