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Preparation for Vascular Operation

Who forms vascular arteries?

When your dialysis time approaches, your nephrologist will refer you to a vascular surgeon experienced in vascular access to prepare the vascular access. Your vascular surgeon will examine your veins at the first meeting and give you information about which vascular access will be suitable.

In our country, vascular access operations for dialysis purposes are generally  It is performed by Cardiovascular Surgeons who specialize in this field.


In choosing a vascular surgeon  What should I pay attention to?

Vascular access operations for dialysis purposes are operations that require advanced experience. For this reason, you should be very careful in choosing a vascular surgeon.  You should choose centers and vascular surgeons who are experienced in this regard.


What questions should I ask the Vascular Surgeon?

-         How many years have you been performing vascular access operations on dialysis patients?

-         How many vascular lines have you had so far  Have you performed (fistula and graft) surgery?

-         How many patients have you performed fistula and graft operations in the last year?

-         What is your average surgery success?

-         Do you perform vascular mapping using Color Doppler Ultrasonography before the operation?

How should I protect my veins for fistula surgery?

If you may need dialysis in the future, it is very important to protect your veins:

-         First of all, the veins in both arms, including the arm on which the operation is planned, should be used very carefully.

-         The arm on which the operation is planned should not be used to draw blood, administer medication, or administer serum.

-         Whenever possible, the veins on the back of the hand or the veins on the foot should be preferred for these procedures.

-         A catheter (subclavian) should not be applied from the shoulder.

-         Neck or groin catheters should be preferred for dialysis purposes.

-         Arm exercises before the operation expand your veins and may increase your chances of success in the operation. Consult your vascular surgeon on this issue.

What does a vascular surgeon do during the pre-operative evaluation meeting?

Your Vascular Surgeon evaluates you on the following issues during the examination:

-         The causes of kidney disease in you, the diseases you have had before (heart diseases, blood diseases, rheumatic diseases, etc.), the medications you use.

-         Blood tests done so far.

-         Detailed examination and evaluation of the arteries and veins in your arm.

-         Damages caused by previous vascular interventions, arm, chest and shoulder operations, and accidents are examined.

What is vascular mapping?

It is the examination of the arteries and veins in your arm using a Color Doppler Ultrasonography device before the vascular access operation. With this examination, the diameter of your vessels, their flow characteristics and whether there is any blockage are examined. Be sure to have vascular mapping done before the operation.


What does vascular mapping provide to the patient?

With this examination, it is decided in which region and with which technique the most appropriate operation can be performed. It also increases the chance of success of the operation and gives your surgeon an idea about the expectation of success.


Who performs vascular mapping examination?

This examination should ideally be performed by the vascular surgeon who will perform the operation. Some surgeons outsource this examination to radiologists. Ask your surgeon who will perform the operation how and where you can have this examination done.

What is Venography?

It is an imaging method that allows detailed examination of the venous system in dialysis patients before vascular access operations.


 Which Patients Should Have Venography?

-         Patients who are inadequately monitored by vascular system examination and Color Doppler Ultrasonography

-         Patients who have previously had a shoulder (Subclavian) catheter inserted.

-         Patients who have had multiple unsuccessful fistula operations

-         Those who had an accident or surgery on the shoulder or arms.

-         To create new fistula or graft operation opportunities in patients whose fistula or graft chances have decreased.


 How is Venography Done?

  Venography examination is performed by radiologists in the Angio Laboratory. Processing time is approximately 5-10 minutes. The process is carried out as follows:

-         First, a cannula is placed in the arm where the procedure will be performed to deliver medication.

-         The patient is then taken to the Angio Laboratory.

-         A medicine that allows examining the veins is given through the cannula.

-         The images created by the angiography device are recorded.

-         All venous processes in the arm and shoulder are examined in detail with images.

What Does Venography Examination Bring to Dialysis Patients? 

-         He decides which surgery is most suitable for you.

-         It increases the success of the operation.

-         It increases the chances of fistula surgery by detecting your veins that cannot be seen by examination and Color Doppler Ultrasonography.

-         It ensures that operations are completed in a shorter time.

-         It allows surgery to be performed with smaller incisions on your arm.

-         It prevents unsuccessful operations and risks that may arise due to blockage of your veins.

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