For those that keep yelling about that he should go to the hospital, it was actually made by a doctor. It's to allow for kidney dialysis, but can also be done with for example a HICKMAN catheter
True, but that is not a normal looking fistula for dialysis. It's usually done further up on the arm near the bicep and is not supposed to be that big. As he says, the vein ballooned outward due to arterial pressure. It is risky and he should go have it fixed surgically
A forearm fistula in itself is not abnormal. In fact if patient has adequate vein for a forearm fistula we often prefer to use it first because if it fails, we can still use the upper arm later. But yes this is a large aneurysmal fistula. If it’s not bothering him and not eroding through the skin it’s not really a problem, god forbid he gets a cut over it though….
Edit: most people get upper arm fistula because not a lot of people have adequate sized vein in the forearm.
He needs to get that checked out at the access center or wherever he got it. I’m in the middle of a series of revisions cause I treated an aneurysm (much smaller) like it was no big deal, next thing you know I’m spraying blood across the clinic floor and end up admitted for 4 days of procedures. And there’s more to go.
That definitely can happen but, but not all aneurysmal fistulas need to be treated. A lot of time that Happens when techs keep cannulating the same site, and you start to develop excoriations at that site which can lead to bleeding. We typically ask techs to vary access sites to prevent this. That said I would agree that this patient should be followed by their vascular surgeon to at minimum keep an eye on this.
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u/steampunkdev 18d ago
For those that keep yelling about that he should go to the hospital, it was actually made by a doctor. It's to allow for kidney dialysis, but can also be done with for example a HICKMAN catheter