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AV Fistula Surgery in Gomti Nagar Extension, Lucknow – Swastik Urology Clinic
Swastik Urology Clinic in Gomti Nagar Extension, Lucknow provides specialised arteriovenous (AV) fistula creation and vascular access care for patients who require haemodialysis. Under the guidance of Dr. Aditya Sengar (Urologist), we focus on durable, infection-resistant access with careful preoperative evaluation, precise surgical technique and structured follow-up.
What is an AV Fistula?
An AV fistula is a surgically created connection between an artery and a vein,
commonly in the forearm or upper arm, that provides high-flow, reliable access
for haemodialysis. Compared to temporary catheters, a native fistula has a
lower risk of infection, thrombosis and long-term complications.
Creating a fistula requires evaluation of vessel size and blood flow using clinical examination and ultrasound mapping to choose the best site and type.
Creating a fistula requires evaluation of vessel size and blood flow using clinical examination and ultrasound mapping to choose the best site and type.
Durable Vascular Access for Dialysis
A well-planned AV fistula can last years and reduces the need for
temporary catheters, lowering infection and hospitalization risk.
Preoperative Vessel Mapping & Personalised Planning
We perform Doppler ultrasound mapping to assess arteries and veins and
select the optimal fistula type and location for each patient.
Options: Native Fistula or Graft
Native radiocephalic or brachiocephalic fistulae are preferred, but when
native vessels are unsuitable we offer graft placement for reliable access.
Fistula Monitoring & Revision
Early identification of stenosis or low flow lets us perform timely
interventions (surgical or endovascular) to salvage the fistula and avoid
catheter dependence.
Who Needs an AV Fistula?
AV fistula creation is indicated for patients who require long-term haemodialysis
because of chronic kidney disease (CKD) or end-stage renal disease (ESRD).
Ideal candidates are identified after nephrology consultation and vascular assessment. Early referral for fistula planning (before dialysis becomes urgent) improves outcomes and increases chance of successful maturation.
Ideal candidates are identified after nephrology consultation and vascular assessment. Early referral for fistula planning (before dialysis becomes urgent) improves outcomes and increases chance of successful maturation.
How is AV Fistula Surgery Performed?
The procedure is usually done under local anaesthesia with sedation or regional
block:
1. Preoperative Mapping – Doppler ultrasound identifies suitable artery and vein.
2. Small Incision & Anastomosis – A small incision is used to connect artery to vein (end-to-side or side-to-side), allowing the vein to enlarge and arterialise for dialysis access.
3. Closure & Dressing – Incision is closed and a dressing applied. The arm is protected and instructions provided for care.
Postoperative care includes wound checks, arm exercises and regular monitoring of thrill and flow. Ultrasound checks are done if maturation is delayed.
1. Preoperative Mapping – Doppler ultrasound identifies suitable artery and vein.
2. Small Incision & Anastomosis – A small incision is used to connect artery to vein (end-to-side or side-to-side), allowing the vein to enlarge and arterialise for dialysis access.
3. Closure & Dressing – Incision is closed and a dressing applied. The arm is protected and instructions provided for care.
Postoperative care includes wound checks, arm exercises and regular monitoring of thrill and flow. Ultrasound checks are done if maturation is delayed.
Why Choose Swastik Urology Clinic for AV Fistula Care?
Swastik Urology Clinic is committed to predictable vascular access:
• Multidisciplinary Approach
Close coordination with nephrologists and dialysis teams ensures access planning, timing and usage are optimised for each patient.
• Experienced Surgical Technique
Precise microvascular technique and careful vessel handling reduce complications and improve maturation rates.
• Access Salvage & Revision
We provide timely interventions for stenosis, thrombosis or other issues to prolong fistula life and avoid catheter dependence.
• Patient Education & Follow-up
We counsel patients and dialysis staff on fistula care, exercise, infection prevention and signs that require urgent review.
• Multidisciplinary Approach
Close coordination with nephrologists and dialysis teams ensures access planning, timing and usage are optimised for each patient.
• Experienced Surgical Technique
Precise microvascular technique and careful vessel handling reduce complications and improve maturation rates.
• Access Salvage & Revision
We provide timely interventions for stenosis, thrombosis or other issues to prolong fistula life and avoid catheter dependence.
• Patient Education & Follow-up
We counsel patients and dialysis staff on fistula care, exercise, infection prevention and signs that require urgent review.
When should I get a fistula created?
Patients with progressive chronic kidney disease who might require dialysis within months should be referred early for vascular mapping and fistula planning. Early creation improves the chance of successful maturation before dialysis is needed.
How long before dialysis can the fistula be used?
Fistula maturation usually takes 4–12 weeks. The exact timing depends on vessel quality and how well the vein arterialises. Your dialysis team will only use the fistula after clinical and/or ultrasound confirmation of adequate flow and size.
What are common fistula problems and signs to watch for?
Watch for decreased thrill or bruit, swelling of the arm, increasing pain, redness or fever. These can indicate stenosis, thrombosis or infection and require prompt assessment to salvage the access.
How do I look after my fistula?
Avoid tight clothing or blood pressure measurements on the fistula arm, perform prescribed arm exercises, keep the site clean, and report any changes (reduced thrill, swelling, fever) to your care team immediately.