My new fistula is too short. What to do?

[RightSide]

On April 3, I had my fistula operation in my left wrist, to create a fistula (my first one) in my left forearm.

I saw my surgeon again today, to have him remove the sutures and check things over.  He said that he could only hear the bruit sound for not quite 5 inches of the vein.  After that point, he thinks that the vein may branch off, or maybe there's some scarring there, and that's why he's not hearing any bruit past that point.  He said that if the ball-squeezing exercises don't improve things, I may need revision surgery.

This surgeon was highly recommended to me by some friends whom I trust, so I am disappointed.  Did my surgeon botch the operation, do you think?  Should I get a second opinion from another surgeon before proceeding further?

[Rerun]

Do you have insurance?  It seems if you have insurance you will have more surgeries! $$$$$$

Yes, you will probably have to have another surgery.  ALL surgeons think they are Tops, so a second opinion will only get you another one who thinks they can do better.

Five inches is still workable but not for long.

[oleboy]

I would check with your Neph to see what he thinks, with my fistula, left lower forearm and my surgeon saying I had small viens, my thrill did not start till after 2 weeks of using the ball. Good Luck

[circleNthedrain]

It may be a little early to woory about what next.  Fistulas mature and grow bigger with time and exercise.  Best of luck!

[bette1]

I'm interested in your outcome because I have the same problem.  I am supposed to get a revision on my fistula (upper arm).  It works, but it is just a bit too deep so they want to move it up.  I really don't want another surgery

[shelly]

RightSide....I had the same problem with my 1st fistula due to scarring that was from IV's from a past illness.  So, after seeing another Dr because I felt like you do that the original vascular surgeon had botched the job.  The 2nd opinion Dr told me that my original Dr. was qualified and since he did not take my insurance (I had to pay to see him out of pocket$$$) it was in my best interest to have the 2nd fistula done.  So after all that I did and ended up having 3 angioplasties even after the 2nd fistula (because of small veins). That was done between 10/31/08 till 1/2/09.  After all that my fistula is up and running since 2/2009.

[G-Ma]

I have small veins and after seeing the Vascular Surgeon who did my fistula I knew I would be having 2 procedures..the first to creat the fistula in my lower arm before the elbow and then 6 weeks later he went in and lifted the fistula to my upper arm so it is longer and just below the skin..works very well.

[paddbear0000]

I have small veins and after seeing the Vascular Surgeon who did my fistula I knew I would be having 2 procedures..the first to creat the fistula in my lower arm before the elbow and then 6 weeks later he went in and lifted the fistula to my upper arm so it is longer and just below the skin..works very well.

My vascular surgeon said the exact same thing. I ended up with a graft though because my veins weren't good enough though. When you say you have 5 inches, what are you talking about? I have a loop graft, so I can't picture what you are referring to. I definitely don't have 5 inches on either side of the loop for each of my needles. Now I'm concerned.

[G-Ma]

Mine is a straight fistula going from my inner elbow straight up about 6 inches to my underarm.

[RightSide]

My vascular surgeon said the exact same thing. I ended up with a graft though because my veins weren't good enough though. When you say you have 5 inches, what are you talking about?

Well, I meant that if I take a ruler and measure from where I can first feel the thrill to where I can no longer feel the thrill, that's a bit less than 5 inches.

[BRANDY]

Now I am worried ,  My thrill is in only one spot. there isnt any inches there .  One finger is what you can feel  in one area.  My actual  vein is about 5 inches.  but the thrill isnt all the way down it.  You can hear down it somewhat.

[paddbear0000]

If I understand my nephrologist correctly, you will only feel the thrill where the vein and artery (or tube/artery/vein if it's a graft) actually connect to each other. It is the bruit that you should be hearing the entire length of the fistula or graft. You probably need a stethoscope to listen for it though.

[BRANDY]

thanks paddbear , I do hear it all the way down vein.  that is great  I thought I might have a problem.

[del]

Some fistulas take time to develop.  Hubby's was done in 2000 and it goes from his wrist to above his elbow!!  You can hear the thrill all the way up!!

[paddbear0000]

The thrill is what you feel and the bruit is what you hear.