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?

Your heart is the most important and vital organ of all and regulates the flow of heart to all parts of the body. Thus, the valves and the arteries which take the blood to your heart are also an important component in ensuring that the circulation is constant. Thus, any hindrance to this process will put a lot of pressure on your heart and lead to more serious problems in the long run. Coronary artery disease is one such problem and can seriously put the health of your heart at risk.

What is coronary heart disease?
Coronary arteries are very important blood vessels, which carry nutrients, blood and oxygen to your heart. If the level of bad cholesterol is high in your blood, it will start leaving deposits on the walls of the arteries which are commonly known as plaque. This plaque will start building up over time causing blockage of the arteries and disrupting proper blood flow. Excessive build up of the plaque may then rupture the lining of the plaque. This will then induce blood clotting and further prevent the normal flow of blood.

Symptoms
Primary symptoms may include

Shortness of breath: This may occur while you are exercising or performing activities which are mildly exerting.
Heart beats very hard and fast: Your heart may beat very hard and fast, especially when doing everyday activities such as climbing stairs or walking for a prolonged distance.
Angina or chest pain: You may experience pain in your chest as if someone was pressing against it with a lot of force. Angina is also triggered due to stressful activities or even emotional stress. It usually occurs on the left or the middle of the chest and may even be felt in the back, arms, and neck.
Heart attack: Heart attacks are the most common and the most serious complications of coronary heart disease. You would feel extreme pain, akin to crushing on your chest, shoulder, or arm. It may even be accompanied by jaw pain, and sweatiness.
Treatment
Non invasive forms of treatment are always preferable rather than invasive surgeries or procedures to treat coronary heart disease, especially where the risk of serious complications such as heart attack are still on the lower side. Some of the treatments used for coronary heart disease are as follows:

Making lifestyle changes: Quit smoking, reduce alcohol consumption along with consumption of regulated diet will automatically start cleaning plaque that has built up within the arteries. Losing weight also tends to help.
Medications: Special medications can take care of cases wherein the deposits are still lesser and the plaque buildup can be removed without the requirement of extensive surgery. Anti-cholesterol medications are one example of this.
Surgical procedures: These are usually employed when the blockage is severe and cannot be corrected by the conventional methods mentioned above. Some of the procedures are angioplasty, stent replacement, as well as coronary artery bypass surgery.

Coronary Artery Disease -  Know the Primary Signs!

Coronary artery blockage is the most common heart disease and also causes of premature death in the present era. Comparatively, male sex is more prone to the Arterial Blockages than females. Heart muscles need a regular blood supply, oxygen molecules and nutrients to function properly. Heart muscles need a regular blood supply, oxygen molecules and nutrients to function properly. Coronary arteries are those which supply blood to the heart muscles, any blockage in the coronary arteries causes decreases the supply of blood to the heart muscles. Coronary artery blockage is caused due to the build-up of the cells, fat and cholesterol which is called as plaque, which leads to lack of blood supply to the heart muscles.

When the person is active and takes too much stress, the heart needs, even more, blood supply, but when the coronary artery is blocked then there will be a lack of blood supply to heart muscles, such a condition is known as ischemic heart disease. Common symptoms of ischemic heart disease are

Irregular heart rhythm

Shortness of the breath

Angina pain

Tightness in chest

These symptoms take time to appear, but with the gradual decrease in oxygen supplied by the blood the muscles of the heart can get damaged, sometimes even permanently and that is what happens in a heart attack. If someone is suffering from ischemia since long, then it can lead to irregular heartbeat and heart failure.

Tests conducted for detecting coronary artery disease:

Electrocardiogram

Exercise Stress

Nuclear Scan Test

Stress Thallium Test

Cardiac Catheterization

You doctor based on your medical history and symptoms will refer a particular test.

Treatments

If the coronary artery disease is diagnosed, then there are a number of ways it can be treated including lifestyle changes, medication, procedure or surgery

Lifestyle changes: It includes daily exercise, changes in the diet and strictly no smoking

Medication: In the allopathic system of medicine, medication can only help treat the symptoms of blocked coronary arteries, it cannot fix them.

Ayurvedic Approach: The way of understanding of medoroga prakarana according to yogaratnakara and other acharyas are unique. Even stoulya and medoroga is caused due to medo vruddi. Our acharya explains stoulya prakarana and medo roga prakarana in separately. It indicates that Stoulya includes fatty deposition in the adipose tissue. Likewise Medo roga including fat molecules and plasma cholesterol in the blood. Due to the more quantity of the fat molecules and plasma cholesterol in the blood, it can cause several disorders including coronary artery blockage, gallbladder stones, PCOD, Hypothyroidism, X-syndrome etc.

Clinically sometimes a person may be lean but can suffer from coronary artery disease or gallbladder stones, hypercholesterolemia, higher plasma cholesterol levels. Sometimes, we can t find these conditions in obese persons, but they are more at risk of suffering from these problems.

Ayurvedic Medication:

Line of treatment:

Hrudya vati 1000mg 2 times a day before food can be helpful

Anarsha Kshara 3 pinch before food.

Sukha virechana Churna 1tsb after food will surely help

Note:

At the plaque formation stage in arteries and before the thrombus (blood clot) formation, plasma cholesterol management is required and for this Hrudya vati is highly recommended
With the help of above mentioned ayurvedic medicines, we can easily treat coronary artery blockage of 10 to 100%, without any stent or bypass surgery
Anupana: Water, Honey or Ghrutha
Other indications

Prevention of heart attack

Increased blood cholesterol (Lipid Profile Abnormalities)

Gall Bladder Stones

PCOD

Hypothyroidism

Metabolic X-Syndrome.

Conclusion

Coronary artery Blockage is caused due to Medo Vruddi in the blood that may accumulate in the coronary artery vessels. And, will eventually cause ischemia in the heart muscles i.e. craving of the oxygen supply to the heart muscles. That may produce the symptom like irregular heart rhythm, shortness of the breath, angina. After that, it may lead to thrombus formation and can cause myocardial infarction.

Serological Study: Sometimes 100% blockage with cholesterol, fat molecules and cells i.e. Plaque may not show any symptoms, but sometimes even 20-30% of blockage can show all the symptoms. So in the higher cholesterol level or in the hypercholesterolemia conditions and in the early stages of the Plaque formation, one should take medication.

Scientific study:- By observing different scholar s scientific study of all the ingredients of Hrudya vati with respect to regularization of cholesterol level and break down of Plaque formation, we concluded that Hrudya Vati is the drug of choice for the coronary artery blockages.

Animal experiment: Also for further study we conducted an animal experiment on mice in Govt M-Pharma College Bangalore. Experiment result shows serum cholesterol level becomes normal. So that it can prevent the coronary blockage, and reverse the coronary artery blockages.

Clinical study: Through the Clinical study we observed that at the stage of plaque formation in the coronary artery and other arteries can be removed permanently that is 100% by advising Hrudya Vati. 

No need to go for any stunt or bypass operation. With this medication can clear the pathway of the blood vessels, also prevents the blockages & heart attack. In case, there is a family history of heart attack and your blood cholesterol is high, it is advisable that you take at least one course of Hrudya vati, once a year. So, everyone must try to understand the condition of the coronary artery blockage and prevent further complications based on the evidence.

Ayurvedic Treatment For Coronary Artery Blockage Without Surgery!

Formation of blood clots in the arteries of the lungs, heart or legs can actually kill a person. In such a case, the immediate medical action is necessary and the only way to deal with blood clots is thrombolysis.
Thrombolysis or thrombolytic therapy is a medical process that dissolves blood clots and facilitates blood flow to all parts of the body. Thus, it protects tissues and muscles from damage.

What are the causes of blood clots in the body?

  Poor blood circulation
  Conditions such as Deep Venous Thrombosis and atrial fibrillation
  Blood clots can also be formed because of dialysis catheters and by-pass grafts

How can you tell if you have blood clots?

  Swelling in one or more legs
  Cramp and tenderness in the legs
  Breathing trouble might indicate that blood clots have travelled to the lungs
  Sweating and frequent chest pain may suggest that blood clots have travelled to the heart

How is Thrombolysis performed?

Thrombolytic drugs are injected into the body intravenously. They make their way to where the blood clots exist and dissolve them. If there is a medical emergency, the drugs are delivered to the exact location of the blood clots and immediately start dissolving them. Another method is inserting a device into the blood clot infested region to break the clots up. The drugs which on entering the body dissolve blood clots are called thrombolytics. There are many varieties of thrombolytics such as the following-

  Streptokinase - It is a kind of enzyme. It is used when a person has just suffered a heart attack or pulmonary embolism. Doctors do not usually prescribe the second usage of this drug. It is injected into a vein and can be administered to pregnant women.

  Tenecteplase - Also an enzyme, it is a plasminogen activator. When it binds to the surface of the blood clot, it makes the clot degenerate.

  Reteplase - It is actually extracted from E-Coli. It is a sterile intravenous bolus injection

The leading cause of heart attacks and ischemic heart disorder is the formation of blood clots in the arteries that connect the heart and the brain. Thrombolysis is often employed as an emergency treatment for this purpose. Thrombolysis is also effective against blood clots formed in the lungs (which lead to acute pulmonary embolism). Sometimes blood clots are formed in the legs, upper extremities of the body, the pelvic region (deep vein thrombosis). These clots may travel to the lungs and heart.

Consult your doctor before undergoing the treatment.

Thrombolysis - Causes, Symptoms & Treatment Of It!

Varicose veins are bulging blue veins on the legs that can cause leg swelling, skin blackening and even open wounds called ulcers. It is commonly seen in people aged 35 and above who have to stand a lot. Here are a few tips to prevent these:

1. Avoid standing for long periods: standing for long periods of time causes blood to pool in your leg veins and they begin to bulge out like a balloon. Avoid standing desks at your work. If you have to stand, take a 5-minute break every hour and walk around or sit down.

2. Keep weight in check: overweight people have a higher incidence of varicose veins. Keeping your weight in check would also prevent varicose veins.

3. Exercise 30 minutes a day: exercise, especially brisk walking or jogging, will get the blood in your leg veins to circulate and thus prevent varicose veins.

4. Take the stairs: this simple exercise activates your calf muscles and gets blood to circulate in your veins.

5. Be vigilant: calf cramps, swelling, change in colour of skin over foot and open wounds over the feet are a few signs that you need to look out for. Seek medical help to prevent worsening of this disease.

Follow these simple steps and you would be able to prevent varicose veins and have healthy feet.


5 Tips To Prevent Varicose Veins and Varicose Ulcers

What is DVT?

Deep vein thrombosis is a kind of vascular disorder. It happens when a thrombus (blood clot) forms in the deep vein anywhere in the body. It especially develops in the legs. This is a grave ailment and can actually be fatal for you unless you seek treatment right away.

What are the symptoms of DVT?

A worrying feature of deep vein thrombosis is that in most cases it shows no symptoms in the earlier phases. Moreover, what makes diagnosis hard is that even when symptoms manifest, they are very similar to those of other disorders like tissue or muscle inflammation or arthritis.

Here are some typical deep vein thrombosis symptoms:

  One or both of your legs become swollen
  Your legs feel tender and hurt a lot in all postures
  The skin of your legs always feel hot to the touch
  Your skin looks blotchy or discoloured
  You bleed when you cough
  Wheezing and breathing problems
  Dizziness
  Frequent and sharp chest pain

Who is susceptible to DVT?

Deep vein thrombosis usually happens when you sit or lie in one position for long stretches of time especially when you are recuperating after an illness or surgery. It can also happen to you for other reasons-

  Injury: An injury to your legs can narrow the blood vessels and that reduces the blood flow through the veins. That is why blood clots can develop there.
  Pregnancy: The additional weight that woman has to carry in the course of her pregnancy exerts extra pressure on the veins of the legs and pelvis and thus clots may form in the veins.
  Contraceptive pills: Birth control pills raise the chances of a woman getting deep vein thrombosis by four times.
  Obesity: Obesity means forcing extra pressure onto your veins.
  Smoking: Smoking interferes with the flow of blood through your veins and raises the possibility of getting blood clots.
  The family history of deep vein thrombosis: if anyone in your family has deep vein thrombosis, you might contract it too because it is hereditary.

Complications:

DVT becomes lethal if the blood clot becomes dislodged and travels from the legs to the lungs, it can cause a pulmonary embolism. This can lead to blockage of the artery of the lung and in that case, a person may die.

Treatment for deep vein thrombosis:

Treatment for DVT includes both invasive and non-invasive vascular techniques.

  Blood-thinning medicines: They prevent blood platelets from clumping together and reduce the size of the existing clots.
  Thrombolytic drugs: If medicines are not effective, work, these drugs will be injected into your veins. They travel down the veins to where the blockage is and disintegrate the clots so that blood can once again flow through the vein uninterrupted.
  Compression stockings: They exert pressure on the vein containing the clot, prevent it from moving, and do not allow new clots to develop. You have to wear them throughout the day.
  Surgery: In very rare cases, when non-invasive methods have no effect, you may have to undergo a kind of vascular surgery called venous thrombectomy. The surgeon will make a minute incision in the vein where the clot is lodged, siphon it out and then repair the damaged vein.

Deep vein thrombosis is easily curable with treatment. Do not delay it, as DVT has the potential to kill you.

Deep Vein Thrombosis (DVT) - All You Should Know About It!

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