Veins to small for fistual or graft - has anyone overcome this?

[onestronglittlelady]

I had an ultrasound to check for the best placement for a fistula or graft. The doctor said my veins were too small, and the blood flow was too low. I was told if I exercise my arms, I might be able to change this.  Has anyone had success increasing their vein size? If so how did you do it and how long did it take you?

[boswife]

oh goodness!!  have you had more than one opnion?  I do know that you have to do exercises to make your fistula 'mature and develope so i would think that exercise would do the same with or without a fistula present.... but how long??  Hoping you get some answers!  blessings :-)

[Cordelia]

Oh my god, I was told the same thing just yesterday, I went for pre surgery appointment. I want mine in my right arm too, because previous injury I can't stand the BP cuff on my right arm.

What about a graft? That might help, that's what my surgeon suggested if it doesn't work, only problem is, higher chance of infection with a graft.

[ODAT]

my mother was told her veins were too small. They put a graft in her left lower arm. That failed quite quickly. So they told her they were going to put a graft in her upper left arm.
The doctor ended up putting in a fistula! It's been working well. So second opinion is good.

[LoneHighway]

Get a second opinion from a real vascular surgeon, not one who just says they can do that.

[karrye]

My husband had finished chemotherapy in April of 2010.  They delivered it in various veins on both hands and his arms.  When he found out he needed to have a shunt and later a fistula (December 2010), they had the hardest time finding a suitable vein due to the fact chemo had destroyed a number of them.  After consulting several different surgeons and doctors, they finally found one about an inch below his left inner elbow.  So far, so good on the fistula 'maturing'.  So, I sincerely believe you should get a second or even third opinion.

[paul.karen]

A second opinion is good.  Vein mapping is good. 

Have you thought of doing PD?  No needles no veins needed.

[M3Riddler]

I had an ultrasound to check for the best placement for a fistula or graft. The doctor said my veins were too small, and the blood flow was too low. I was told if I exercise my arms, I might be able to change this.  Has anyone had success increasing their vein size? If so how did you do it and how long did it take you?

onestrong,

When someone says that your veins are too small, this means differently to different people. One person may believe that a 2.5mm vine is too small where another may think a 4mm vein is too small.  Definitely get a second opinion from a different affiliation with no ties to the current. Your doctor/nephrologist should willingly give you a referral.

Do you know the actual size of the vein? This is very important....I would call for the records or call and get this information. They should have written a report and sent it to your doctor. Get a copy of this for your records...

Did you have the ultrasound  done at a center that regularly evaluates for fistula's ?
Did they look at more than 1 arm?
Did they ultrasound your entire arm length on both arms?
Did they measure with and with a tournequet? ( most centers do not use a tournequet when measuring, but this can be key in determining)
Did you ever have a venogram ? This is much more detailed and reliable than an ultrasound. When you have an ultrasound, everything matters from the size of the ultrasound head they use to the angle they are looking. You can go to two different places and get two totally different results.

Did you speak with an actual vascular surgeon or just an interventional radiologist? Again this makes a difference....

I have been to 3 different vascular surgeons and received entirely different answers...Each surgeon had their own comfort level when dealing with creating a fistula. One wouldl not touch a vein smaller than 4mm where another had no problem with my vein of 2.5mm

You still have options....It sounds as if they did not do a complete workup on you. Feel free to contact me with a pm to discuss further....