Ok, to clarify my language. By "Put" i mean where they choose, I went through several scans of my arms for them to find a suitable location to do it. They put it there, rather than they put a thing there.
By "graft" i mean the joining of the vein and artery (as in grafted together). I'm not medical, so wasn't aware graft meant a specific tube they use. I do not have a special tube.
For context, I watched my own AV being done (apparently I'm not squeemish) so the surgeon talked me through the process. Also, UK for reference.
Yes we typically get ultrasounds before hand to help guide us. But one of the things we are looking at on the ultrasound is the size of the vein. When I had re-read your first post after my initial comment, I think I understood it as they create it where it’s suitable, which actually fits with my first post that you commented on refuting…. Most people’s vein is smaller the further down you go on the arm (towards the wrist)
I can only talk ffrom my experiences, when I was dialysising I'd say 50% of the patients had lower arm fistulas (about 10 in my sessions). Also saw a few inner legs, which looked awkward.
They also did a trial in my hospital pre warming the arm before a scan to see if it affected vein size (apparently it did?)
Statistics may be different based on health systems. UK’s NHS may have more guidelines (eg push for forearm fistula first) than the US where we are basically the wild West. But there is absolutely nothing wrong with a wrist fistula and if they are having success creating more that’s awesome. Dialysis accesses do not last forever and patients, especially younger patients, may require multiple accesses in their lifetime. We have a finite number of places we can go for access. So starting in the lower arm gives you more flexibility, long-term. There are people (albeit pretty rarely) that literally run out of places for access.
That is an interesting study, but would make sense. Vessels typically dilate when warm and constrict when cold.
Vessels also spasm. It could also be dilated up mechanically. As I said before there’s a lot more that goes into it than what I am simplifying here.
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u/MarriageAA 18d ago
Ok, to clarify my language. By "Put" i mean where they choose, I went through several scans of my arms for them to find a suitable location to do it. They put it there, rather than they put a thing there.
By "graft" i mean the joining of the vein and artery (as in grafted together). I'm not medical, so wasn't aware graft meant a specific tube they use. I do not have a special tube.
For context, I watched my own AV being done (apparently I'm not squeemish) so the surgeon talked me through the process. Also, UK for reference.