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 Artery Disease (PAD) is a disease of blood vessels that are located outside the heart and brain. The condition develops due to fatty deposits in the arteries and veins that stops the blood flow to the heart and mind as the case may be. It narrows the artery and restricts the blood flow, which causes problems to other organs of the body such as kidney, liver, and stomach.


Symptoms of Peripheral Artery Disease-
Peripheral Artery Disease is the most common type of condition in people. Some people may not even notice the symptoms. The symptoms include:

Pain in the hips and lower leg area.
Brittle toenails.
Short breath while taking stairs.
Pain in the calf.
Numbness and coldness in the leg around a calf
Hair loss on legs and feet
Erectile dysfunction in men
Repeated sores and ulcers in legs
Causes of Peripheral Artery Disease-
The most common cause of Peripheral Artery Disease is the deposit of fatty substances inside the arteries. The fatty deposits build in the arteries gradually with a process called Atherosclerosis. Most of the time people do not know that they are facing the problem of Atherosclerosis. With time deposits increase and the arteries become narrow. It restricts the blood flow and causes problems for other organs.
Another cause for Peripheral Artery Disease is clot created in the arteries due to diabetes. Also, this problem is common in diabetic patients and increases with old age.

The risk factors that contribute to the development of Peripheral Artery Disease are high blood pressure, bad cholesterol, obesity, and diabetes.

Diagnosis of Peripheral Artery Disease-
The primary way to test and diagnose Peripheral Artery Disease is to check the blood pressure in the arm and ankles. If the pressure is low as compared to arm in the ankles, one might be facing Peripheral Artery Disease. It is commonly known as the ankle-brachial index. Other ways to determine Peripheral Artery Disease are CT scans, angiography, and blood tests. Since the disease is prevalent and gradually progress, most of the time it remains undetected.

It is essential that Peripheral Artery Disease gets detected and treated well in time. If the condition persists for a more extended period of time, it may result in loss of leg, increased chances of coronary artery disease and carotid atherosclerosis.

Treatment for Peripheral Artery Disease-
The only way to treat Peripheral Artery Disease is to indulge in physical activity. A regular regime of exercise and physical work will help a person to burn fat and makes the arteries fat free. Doctors suggest that daily 30 minutes of walking or gyming will help treat Peripheral Artery Disease with significant effects. One may notice the signs in just a couple of months.

Along with exercise, one also needs to monitor the weight and eating habits. Foods that are rich in fats and bad cholesterol should be avoided. Make changes in the lifestyle and eat a healthy balanced diet. Include fruits and fresh vegetables in the diet and follow a low carb diet for regular food intake. If a person is addicted to smoking and alcohol, then he/she should consider leaving the bad habits for their own good health.

Take Away-
Above are some of the common and tried treatments. However, it is advisable to consult a doctor before opting for any of these options as these treatments are depended upon the condition of the patients.


Learning In depth About Peripheral Artery Disease!

Many people know that smoking causes several problems including cancer, heart disease, and respiratory disease. However, there are other diseases occur because of smoking and chewing tobacco. Buerger's Disease is one such disease in which the blood vessels in legs and arms get blocked. This blockage will interfere in blood flow and results in forming blood clots. These clots will affect both legs and
hands.
Buerger's Disease is also known as Thromboangitis Obliterans. It is a type of vasculitis which causes inflammation in the blood vessels including thickening, narrowing, weakening, or scarring.
Buerger's Disease cannot be cured easily. However, by quitting the use of tobacco and smoking, one can limit the symptoms from getting worse. If a person is not able to quit smoking, he/she might end up
suffering from severe tissue damage. One can also even lose toes, fingers, or other parts of the limbs. This is why quitting all type of tobacco or smoking is the only way to treat Buerger's Disease.

What Causes Buerger's Disease?
As discussed earlier, smoking cigarettes or cigars and chewing any form of tobacco is one of the main causes of Buerger's Disease. Still, the exact cause of this disease is unknown, but in most cases of Buerger's Disease, the sufferer has consumed tobacco products. It is an assumption that chemicals present in tobacco, cigarettes, and cigars may affect the lining of blood vessels, causing them to swell. According to experts, the genes in the body may also cause this disease. It is suspected that this disease is caused by an autoimmune response in which the immune system of the body attacks healthy tissues mistakenly. According to this theory, some people are prone to this disease.

Symptoms of Buerger's Disease-
Some of the most common symptoms of Buerger's Disease are:
  Pain in the hands and feet while exercising
  Stiffness due to reduced blood flow
  Pain at Rest
  Skin ulcerations
  Gangrene of the fingers and toes in severe cases
  Numbness, coldness, or tingling of the feet and hand
  Pale, reddish, or blue-tinted hands or feet.

Diagnosis of Buerger s Disease-
There is a set of tests that can diagnose Buerger s disease. Doctors first ask a person about his/her lifestyle, use of tobacco, and symptoms. After seeing a few symptoms, doctors may perform a test to check the blood flow. He may also look for other diseases that cause similar symptoms. Some of the common test to diagnose Buerger s Disease are:


  Allen Test: The Allen test is a blood flow test. In this type of test, patients squeeze their hand into a firm fist, which pushes out blood from hand. The doctor presses the arteries to slow down the
blood flow of the hand. At this stage, the normal color of the skin gets pale. After that, patients open his/her hand and doctors release the pressure from both sides of the wrist one by one. If it takes a longer time to go back to the normal skin color, it may be an indication of Buerger s disease

  Angiogram: It is a type of X-ray that will help to check the blockage of the blood vessels in the legs and arms. In this test, doctor place catheter (thin tube) into an artery to pump the dye. After
that, he takes X-ray images. Doctors may also perform tomography (CT) or MRI scan for clear results.

  Blood Tests: The blood tests will help the doctor to check if there is any other disease that causes the same symptoms as most of the vascular diseases mimics the symptoms of Buerger s
Disease. The doctor may also perform tests to check for diseases like lupus, diabetes, and those that cause blood clots.

Treatment of Buerger' Disease-
Quitting smoking and use of tobacco will help a person to lower the symptoms of this disease. Doctors may also prescribe for pain killers or antibiotics to get rid of the pain in affected areas. If a person finds it difficult to quit smoking, doctors help him/her with the right program and rehabilitation techniques.

Take Away-
Buerger's Disease is one of the rare illness caused by intake of tobacco products, this is why quitting smoking is most important to treat this disease. It is also advisable to consult a doctor as soon as a person identify any of the above symptoms.

All You Need To Know About Peripheral Vascular Injuries!

Varicose veins and chronic venous insufficiency both affect the veins of the legs. The veins in the legs are equipped with one-way valves, which direct the flow of blood from the legs to the heart. If these valves malfunction, the blood may flow backwards. This blood may collect in small pools somewhere in the veins or the veins may become enlarged and swollen. This causes immense pain that makes it difficult to go about your everyday activities.

What are the complications linked with varicose veins and chronic venous insufficiency? 

Usually, both disorders cause a lot of discomfort and pain. But sometimes the varicose vein may rupture and cause varicose ulcers on the skin of your legs. The blood clot may travel to your heart and it may lead to cardiac complications.

Who is susceptible to varicose veins and chronic venous insufficiency?

Although anyone can get varicose veins or chronic venous insufficiency, women are more likely to develop these venous disorders than men. The chances go up if you are-

  Older than 50
  Obese
  If someone in the family has varicose veins or chronic venous insufficiency
  Pregnant or if you have been pregnant before
  If you have been diagnosed with blood clots
  If you consume alcohol or smoke

Diagnosis of varicose veins and chronic venous insufficiency-

As interrupted blood flow leads to both varicose veins and chronic venous insufficiency, your doctor will conduct a blood flow test through a duplex ultrasound. The sound waves can help determine in which direction the blood is flowing and the speed of the flow.

Treatment of varicose veins and chronic venous insufficiency-

The doctor will ask you to implement lifestyle changes-

  You need to lose weight because being overweight is the chief contributing factor towards both these disorders. Besides regular exercise can improve blood flow through your veins
  Do not sit for long stretches of time. Go for small walks and stretch those legs.
  Medications that can target the pain and the swelling

Surgery:

If medication and lifestyle changes do not work, you might have to undergo surgery. The surgery is performed under general anaesthesia. You can leave on the same day. Not much follow-up care is required.

Sclerotherapy: Another popular option is sclerotherapy . A chemical is injected into the vein that closes it. The scar it produces will disappear within 4-5 days.

Laser therapy: Painless small procedure to close diseases vein.

Open surgery: Small cuts over skin to remove diseases vein.

Both varicose veins and chronic venous insufficiency are accompanied by pain. Medication can help keep the pain and discomfort under check but in severe cases surgery is necessary.

Varicose Veins & Chronic Venous Insufficiency!

Blood vessels are normally hidden under the skin, but a common complaint of people who stand for long durations of time is the appearance of bluish veins on their legs. In most cases, these veins appear twisted and enlarged. This condition is known as varicose veins. Pregnant women also often suffer from this condition.

Causes of Varicose Veins:

Occupational: Standing long hours

Genetic tendency

Deep vein thrombosis: A condition which affects the valves of veins

It might get triggered during pregnancy and due to obesity

Apart from the appearance of veins, the patient may experience swelling of the calf muscles, cramps in the legs and a feeling of heaviness. If left untreated, it could result in the formation of varicose ulcers and other complications.

Homeopathy is a holistic form of treatment that is very effective when it comes to varicose veins. This form of medication does not address only the symptoms, but also takes into account the personality of the person and his or her overall health.

It helps to reduce pain, control further varicosity, reduces swelling. Homeopathy also helps significantly in the cases which have varicose ulcers. Homeopathic treatment is strongly recommended for all cases of varicose veins except for those which are truly surgical in nature.

Homeopathy treats this condition by stimulating the immune system and restorative processes in the body while strengthening the walls of the veins. It has negligible side effects, but should ideally be taken under a qualified homeopath doctor s guidance. Some homeopathic remedies used to treat varicose veins include the following:

Hamamelis: Hamamelis is the most popular homeopathic medicine used to treat varicose veins. This is prescribed in cases where the veins bleed and there is a feeling of tiredness. The patient may also feel the leg muscles becoming sore or bruised and suffer from inflamed varices.

Pulsatilla: This medicine is often prescribed to pregnant women suffering from varicose veins and in cases of varicose veins that are extremely painful. Some of the personality characteristics taken into account when prescribing Pulsatilla is intolerance to heat and thirstlessness.

Calcarea: Painless cases of varicose veins are often treated with Calcarea. However, there may be a burning sensation in the varicose veins. The patient, in such cases, is usually obese, but malnourished and sweats excessively though his/her hands and feet stay cold.

Graphites: Varicose veins that are excessively itchy can be treated with Graphites. It is also effective in cases where the patient suffers from cramps in the legs and other skin problems. Patients who benefit from Graphites for varicose vein treatment are often obese and suffer from constipation.

Arnica: Arnica is often used to treat varicose veins that are sore and bruised. In such cases, the patient s legs may also have blue black discolouration and they may appear as if they had been beaten. Any kind of exertion aggravates the symptoms.  

Homeopathic Remedies For Varicose Veins

Varicose veins are a condition marked by enlarged or gnarled veins. This typically affects the veins in the feet and legs. In most cases, varicose veins are a mere cosmetic concern but in some cases, it can be quite uncomfortable and painful. If left untreated, it can also lead to further complications.

Varicose veins may be caused by a lack of elasticity in the veins causing blood to pool in them and flow back-wards. This blood is deoxygenated and hence the veins appear blue. Women have a higher risk of suffering from varicose veins as compared to men. This risk also increases with age and weight. Pregnancy can also cause varicose veins. The most common symptoms of this condition are:

visible veins just under the surface of the skin
veins that appear blue and gnarled
a dull ache in the legs
throbbing or burning sensation in the calves
pain in the legs that worsens after standing or sitting in the same position for a long time
itching around the veins
bleeding veins
inflammation of the skin or ulcers around the ankles
red or blue spider veins
Varicose veins can be treated with simple home remedies. Keeping the legs raised or wearing compression stockings can relieve the pain associated with varicose veins and prevent the condition from worsening. Exercise can also help improve blood circulation. If these home remedies are not effective, the patient may need to consult a doctor.

Varicose veins cannot be completely prevented. However, an individual can reduce the risk of suffering from this condition. Regular exercise and maintaining a healthy weight is crucial to do this as being overweight can increase the pressure on the legs and hence aggravate varicose veins. Women with a family history of varicose veins should also avoid wearing high heels and tight stockings.

Complications caused by varicose veins are rare. However, some people may experience bleeding on the surface of the skin. There are chances that the veins deep inside the muscle may get twisted which may lead to the swelling of the calf muscles. Varicose veins may also cause painful ulcers around the ankles and is a result of the buildup of fluid around the ankles.

All the complication must be reported to the doctor at the earliest to prevent the condition from worsening.

Varicose Veins - The Most Common Symptoms Your Should Know!

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