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?

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!

Varicose veins are twisted, enlarged superficial veins that typically appear in the feet and legs.
For many people, the condition is simply a cosmetic concern while for others varicose veins include symptoms like swelling, discomfort and aching.

What Causes Varicose Veins?
Doctors believe that damaged or weak valves may cause varicose veins. Arteries carry oxygenated blood from your heart to other parts of the body and the veins send it back to your heart for recirculation. The veins of your lower body need to work against gravity in order to return the blood to your heart.
Muscle contractions in the extremities act as pumps while the elastic vein walls send blood back to the heart. Small valves open in your veins as blood flows to your heart, and then close again to prevent the blood from flowing back. If these valves become damaged or weak, blood may flow back and accumulate in the veins, causing it to twist or stretch.

Symptoms of Varicose Veins
You may experience the following signs if you have varicose veins  
  Discoloration of the veins   usually they appear blue or dark purple
  Legs feel heavy
  Itching around the affected veins
  Muscle cramps
  A throbbing, burning sensation
  Swelling and bruising
  Discomfort and pain the veins of the legs

The symptoms of varicose veins are quite prominent and require treatment. If the condition is not that severe, exercises and compression stockings may be prescribed to manage the symptoms. However, if you are looking for a long-term cure, laser treatment may be the best option for you.

Can Laser Treatment Cure Varicose Veins?
Your doctor may use highly focused laser beams to treat varicose veins. The laser emits heat, which forms scar tissues. The scar tissue closes the vein so it loses its source of blood and eventually dies. In a year or two, the vein is likely to disappear.

Here are the different types of laser treatment you can opt for  
  Simple Laser Treatment   The laser beams are focused on the outer surface of the skin. It helps cure the tiny veins that are located just beneath the skin. Normally, more than one session of laser treatment is required. Your doctor may schedule you for a session every 6-12 weeks.

  Endovenous Laser Treatment   This type of laser treatment is directed towards treating larger varicose veins that appear in the legs. The doctor passes a laser fiber through a catheter (a long, thin tube) into the veins. While doing this, he/she keeps a close watch on the veins through a duplex ultrasound screen.

Laser treatment is less painful than other procedures like vein stripping and ligation. The entire procedure can be done while you are on local anesthesia or sedatives. Moreover, the time for recovery is relatively short. You can expect to get back to your routine activities in a week or two following laser treatment.

Laser Treatment For Varicose Vein!

What are varicose veins? 
Varicose veins are enlarged veins that typically develop in the legs and the feet. This condition is triggered when there is something wrong with the valves of the veins. When the valves do not function properly, blood flow to all parts of the body is disrupted. Since the legs are the farthest part of the body from the heart, gravity makes it difficult for blood to flow up to the heart. It is a common affliction and affects nearly 25% of the adult population all across the world and 10 million people in India are diagnosed with it every year. The raised veins just under the top layer of the skin appear to be purplish-blue.

Varicose veins are common in people who are -
  Above 50 years of age
  Long stretch sitting
  Pregnant
  Menopausal
  Obese
If someone in your family has a history of varicose veins, you are quite likely to get it too.

What are the symptoms of varicose veins?
Varicose veins are characterized by the following symptoms -
  The most obvious symptom is the large twisty veins
  Pain all down the length of your legs
  Discoloration of the skin of the legs and feet

Diagnosis of varicose veins -
The doctor usually diagnoses varicose veins by a physical examination. An ultrasound may determine if your flow of blood is affected. It is a non-invasive procedure and is done with the help of high-frequency sound waves.
You may even have to undergo a venogram. The doctor injects a colored dye into your veins and X-rays them. The dye gives an indication of how well your blood is flowing through the veins.

Treatment of varicose veins -
There are several treatment options for varicose veins-

Vascular surgery - When the other methods do not work, doctors prescribe vascular surgery.
Ligation and stripping - through this surgery, the surgeon ties up the vein to prevent pooling of blood in the veins and sometimes the vein itself is removed.
Sclerotherapy - the doctor injects a chemical right into the varicose vein which closes it.
Radiofrequency ablation - the doctor uses radiofrequency to heat the varicose vein up, which makes the walls collapse
Varicose veins are a painful condition that can be avoided if you implemented a few changes to how you live your life and even if you do get them, there are ways to cure them.

In Detail About Varicose Vein & Its Treatment!

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?

The veins are a type of blood vessels which collect impure blood from all parts of the body and return it to the heart. The veins in the legs especially are quite thick and need to exert extra pressure to pump blood against gravity towards the heart. In quite a few people, these veins could be engorged, swollen, and twisted, which are known medically as varicose veins.

Causes:
Defective or damaged valves in the blood vessels. Normally, the blood flow is controlled by valves which ensure blood flows in the desirable direction. When these valves are not able to control the flow of blood, then varicose veins can return
Thin vein walls can lead to improper flow of blood, resulting in varicose veins

Risk factors:

Prolonged standing
Obesity
Pregnancy
Smoking
Surgery in the leg, which could have hampered the values or veins
Age, as the elasticity of the vessels, reduces with age and can impede normal blood flow
Family history
Symptoms:

Blue, swollen veins in the legs which are thin and ropy
Pain with prolonged standing followed by pain and tenderness
Itching and heaviness in the legs
Cramping in the night
Blood clots in the superficial vessels
Severe varicose veins can cause bleeding
The area around the leg feels firm and/or hard
There could be skin changes like scaling, dryness, and color changes
Increased propensity to bleed in the affected leg
Diagnosis:

Usually easily diagnosed in clinical examination
The above-listed features are very characteristic and help in identifying them
Further testing may be done to identify the problematic valve, usually using a tourniquet
Doppler ultrasound, scanning, and MRI may be required to confirm diagnosis, which are quite rarely used
Prevention/Treatment:

Keep the legs elevated as much as possible. During working hours, take short breaks where you are able to elevate the legs
Even in prolonged journeys, try to take a break which will improve circulation
Quit smoking
Compression stocking (Ted hose or Jobst stocking) can be used to improve circulation. They also help in controlling pain and are very commonly recommended to treat varicose veins
Avoiding alcohol, which leads to venous dilation
Weight management, as being overweight is a big risk factor
Do not cross legs when sitting, as it puts constant pressure on the valves
Avoid tight clothing which can put pressure on the veins and/or valves
Keep a regular exercise regimen like walking to improve blood flow
Surgical treatment options include sclerotherapy, laser treatment, and stripping off the vein, but are not usually required.

Varicose Veins - 9 Signs You Are Suffering From It!

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