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?

Every woman wishes for great legs they can flaunt in tiny shorts and skirts whenever they feel like it. The greatest impediment to this freedom, however, is unattractive spider and varicose veins that make legs lose their aesthetic value and limit women from enjoying experimenting with short outfits. Not only do these veins look unattractive on legs, but they are quite painful as well. The good news is that modern medicine has enabled doctors to use the body's own healing mechanisms to amend the problem. Doctors can now employ the use of laser treatments and injections to provide quick relief to patients. What's more, these treatments can be addressed easily in a doctor's office and require short visits, and you can walk comfortably out of the doctor's office on your own.

How it works
Minimally invasive laser treatments and injections are used to collapse and then shrink the affected veins. Thereafter, the veins are then absorbed into the tissue that underlay this, and will bring a clear effect such that all the visible traces will be gone. The surrounding healthy veins will then take control and restore the normal circulation of the body. While there might be some little bruising noticed, it will only last temporarily.

Options available
Today the treatments for these veins are improved and what's more, the process is much more comfortable. This is unlike the past where thick, uncomfortable, elastic compression socks were used to relieve pain and the procedures involved a surgery where veins are stripped out of the leg and patients are put under anesthetics. The options that are available today include endovenous laser ablation where a map around the abnormal vein is created with ultrasound, a catheter inserted into the vein and a laser carefully passed through the catheter generating a controlled amount of heat that will seal the vein and redirect blood to the healthy vessels. There is injection sclerotherapy where a pharmaceutical liquid is injected into the vein that will cause the vessels walls to adhere and then seal shut and the blood instantly gets directed to healthier veins while the treated vein disappears. Laser sclerotherapy is reserved for tiny superficial veins and may not get injected.

While there is no cure for varicose veins, a doctor can prescribe post treatment instructions that will minimize the chances of a patient getting the veins again. Things like managing diet, exercise and good lifestyle choices are among them. Also routine monitoring is the key to preventing future reoccurrences.

Want Beautiful Legs? You Can Opt for Vein Removal Therapy

Peripheral Artery Disease (PAD) is caused by atherosclerosis or plaque build-up in the leg arteries. Mostly, individuals with PAD have mild or no symptoms. But with the extension of the blockages, individuals may experience disability and pain that restricts free walking. In more severe cases, individuals may develop a risk of losing their limb if the circulation is not improved. 

There are various ways to improve the flow of blood in the leg, especially for individuals with severe PAD. The objectives of improving the blood flow in the limb include improving functional ability, reducing pain, preventing amputation, and providing a better quality of life. 

Symptoms 

Symptoms of Peripheral Artery Disease may include gangrene, claudication or pain in leg muscle while walking, pain at night mainly in the feet and leg, and feet sores.

Bypass Surgery

There are a number of treating methods for PAD. Both invasive and traditional methods are used to treat Peripheral Artery Disease. 

Stenting and Angioplasty are invasive treatment methods. The traditional method includes bypass surgery. The best available treatment method for an individual depends upon various factors such as severity, location of the artery blockage in the leg, general health of the patient, history of any vascular problems, and previous treatments.

Surgical bypass in the leg or Lower Extremity Bypass Surgery is usually the last option for the patients with PAD. This method is used when all the other alternative treatment methods fail or are not suitable for the individual. During the Leg Bypass Surgery, the surgeon forms an alternative channel for blood flow to bypass or avoid the blocked area and restore the direct flow of blood to the lower leg and foot. 

The risks and benefits of the surgery are calculated prior to the surgery. For the best result of the surgery, surgeons try to use the patient s own saphenous vein, from inside the leg, to execute these grafts. Surgeons may also use veins from other leg or arms or use prosthetic or artificial graft, in case the required length of the saphenous vein cannot be achieved. 

The results of artificial and saphenous vein from other limbs are not as effective as the saphenous vein from the same leg. Thus, the availability of an appropriate vein to execute this method is an important consideration that is taken into account before the surgery. 

Takeaway

Leg Bypass Surgery is one of the medical procedures for the treatment of Peripheral Artery Disease. In PAD, the artery of the leg is blocked which can hinder the daily life of the individual. 

The symptoms can be mild or absent but, in the case, where symptoms are severe, and affecting the quality of life of the patient, treatment becomes a necessity. Bypass surgery is the last option used when other alternative methods fail to help the patient. 

Leg Bypass - Know More About It!

The coronary arteries supply the heart with oxygen-enriched blood and nutrients. If these arteries become damaged or diseased; they could cause Coronary artery disease or CAD. Plaque deposits on the walls of the arteries are the most common cause of this disease. This plaque is usually the result of high cholesterol levels. As the plaque builds up, the passage of blood flow is reduced. This reduces the amount of blood that reaches the heart. In cases of a complete blockage, CAD can even cause a heart attack. Because of its slow progression, this disease is often not diagnosed until it reaches a dangerous stage. However, it can be prevented and treated if diagnosed in time.

In the early stages of CAD, symptoms are not very noticeable. Symptoms become visible only when blood flow to the heart reduces and the heart has to pump harder than normal. The most common symptoms experienced include:

Chest Pain: This is also referred to as angina. It may feel like a tightening of the chest or pressure on the chest as though someone is pressing against it. This type of chest pain may be triggered by emotional or physical stress. It is usually relieved within a few minutes of stopping the activity. Women may experience this pain as a sharp, fleeting pain in the back, arm or neck.
Breathlessness: When the heart does not receive enough blood, it has to work harder to pump blood through the body. This may be translated to breathlessness of shortness of breath when performing any type of physical activity. It can also cause extreme fatigue.
Heart Attack: A heart attack is the most severe symptom of coronary artery disease. This is caused by the complete blockage of a coronary artery. A heart attack can occur without any symptoms or be preceded by slight symptoms. The signs of an impending heart attack include pain in the chest and shoulder, shortness of breath and extreme sweating. The chest pain may also travel to the lower jaw. These symptoms are more pronounced in men as compared to women. Women have a higher tendency of experiencing atypical signs such as extreme fatigue.
Other symptoms that might indicate coronary artery disease are dizziness, nausea and an irregular heartbeat. The good news is that this disease can be prevented. Staying physically active, maintaining a healthy weight, reducing stress and eating a low fat and low salt diet can help reduce the risk of CAD.

Coronary Artery Disease (CAD) - What Are The Symptoms?

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

Varicose veins are large veins that appear on the legs of some patients. Usually, blood travels to the legs from the heart through the arteries, and the veins take it back to the heart. The valves in the veins allow the blood to travel from the legs to the heart against gravity. During this process, the valves may leak and blood may collect in the veins, making them appear enlarged.
EVLT (Endovenous laser therapy) is the latest method for curing varicose veins without surgery. It heats the affected veins them through a laser instead of removing them.
Process
In this process, at first, an ultrasound scan is carried out to locate the veins that have to be treated. After marking them, the doctor applies local anaesthetic on the skin and a needle is inserted into it. A wire is then passed through the needle up to the target vein. Over this wire, a catheter is passed after removing the needle. After that, the wire is removed.
Through the catheter, a laser fibre is placed whose tip usually reaches up to the groin crease. Using tiny needles, a large amount of local anaesthetic solution is applied in the region surrounding the vein. The laser is then applied for 5 minutes on the veins. You might hear a buzz or feel a burning sensation but won t feel any pain. The catheter and the laser are then removed and the incision is covered.
The process takes about 30 minutes to complete. After the treatment, you will be advised to wear compressions stockings and can go back to your normal routine immediately.
Benefits
The different benefits of the surgery are:
The skin does not have to be stitched 
There is no pain in the process and patients can go back to work right after the treatment
The process is free from complications 
No scars are left after the treatment

Common uses of the process
EVLT is also used for treating the following:
Swelling of the veins 
Discolouration of the skin
The heaviness of the leg
Skin ulcers and irritation
Precautions
These are the precautions that you must take:
A week before the process, avoid taking arthritis medications, aspirin, and Ibuprofen as they can increase the chances of bruising 
Avoid alcohol and tobacco 2 days before the procedure
After the treatment, ask someone to drive you back home and do not use public transport
Avoid activities like swimming, running, jogging and weightlifting for at least 2 weeks after the procedure

The varicosities fade away after the process but rarely disappear completely. You might require further treatment for improving the appearance of the veins. 


EVLT Varicose Veins Treatment!

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