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cassandra
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When all else fails run in circles, shout loudly

« on: April 15, 2019, 01:22:43 PM »

Hi all, has anybody had a fistula closed down by intervention radiology? I was told by several surgeons (including
Super Surgeon who made my new fistula in uhm a lot of operations) that my old fistula needs closing down. Apparently :”nobody in their right mind would consider cutting in my old fistula arm. The amount of collateral veins is too huge.”


But my old arm is ‘splitting’ and spontaneously bleeding, so they’ll do it from the inside.


Any info welcome 😃
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I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
       still on waitinglist, still ok I think
rcjordan
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« Reply #1 on: April 15, 2019, 06:56:26 PM »

Probably like closing pancreatic fistulas.

"Treatment consisted of vascular coil implanted at the entry of the fistula and then sealed with tissue glue adhesive during endoscopic procedure. Technical success of vascular coil implantation and the use of tissue glue adhesive were reported in all patients"

The Use of Interventional Radiology Techniques in the Treatment of Pancreatic Fistula. - PubMed - NCBI
https://www.ncbi.nlm.nih.gov/pubmed/27846166
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Coastal US, NE North Carolina
2018 right nephrectomy - cancer. Left kidney not filtering, start hemo. After 3 months, start Nxstage home hemo
Charlie B53
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« Reply #2 on: April 18, 2019, 09:37:39 AM »


I've no idea about closing off a fistula but I have had the sophis (Sp?) vein down the front side on my shin closed off.

Dr's told me that vein was a primary cause of my legs swelling and leaking so they wanted to close it off.

Made a smal incision just below the knee, snaked a lasar in and down almost to the ankle, zapping the inside of the vein every couple of millimeters as they pulled it back up and out the opening.

I was dope d enough I don't think I hardly felt a thing.
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GA_DAWG
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« Reply #3 on: April 18, 2019, 09:18:11 PM »

Cassandra, do you mean the skin is splitting and bleeding on the outside or the fistula itself is splitting and bleeding internally? Sorry to ask, but I've never heard of this.
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cassandra
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When all else fails run in circles, shout loudly

« Reply #4 on: April 19, 2019, 03:36:58 PM »

Cassandra, do you mean the skin is splitting and bleeding on the outside or the fistula itself is splitting and bleeding internally? Sorry to ask, but I've never heard of this.


This fistula arm has severe narrowings in the fistula. Oedema was in that arm from the moment the fistula was made in '98. So the skin where all the cutting happened to get into the fistula for plasties is splitting. The fistula itself is completely calcified so I can see that. It's pretty sickening
« Last Edit: April 19, 2019, 03:39:04 PM by cassandra » Logged

I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
       still on waitinglist, still ok I think
PrimeTimer
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« Reply #5 on: April 19, 2019, 07:46:10 PM »

Cassandra: If I could I'd give you one a couple of the cupcakes my husband brought home from the bakery today. Sweets always cheer me up. Hope this fistula ordeal works out for the better for you.

Here's wishing you a Happy Easter and even better weekend!  :basket: :bunny:  (we need a chocolate bunny and some of those marshmallow peeps!)
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Husband has ESRD with Type I Diabetes -Insulin Dependent.
I was his carepartner for home hemodialysis using Nxstage December 2013-July 2016.
He went back to doing in-center July 2016.
cassandra
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When all else fails run in circles, shout loudly

« Reply #6 on: April 20, 2019, 08:39:44 AM »

Thanx PT.  :cheer:


Wishing you a Bunny Easter too


   :cuddle;
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I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
       still on waitinglist, still ok I think
Charlie B53
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« Reply #7 on: April 21, 2019, 09:15:19 PM »


This may be a totally stupid response as I haven't half a clue.   But........

I would think that the Vascular Surgeon could open the arm, tie off the souce and again tie off farther down the damaged vain, then strip out the damaged vein, closoing the arm and letting it heal.

Sure the access site would be gone requiring creation elsewhere.  But this should stop the swellilng and the skin spliting.

Is this not an option?      It seems to make sense to me, but then again, I am just a guy, a mechanic.   I don't get to work on people.
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cassandra
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When all else fails run in circles, shout loudly

« Reply #8 on: April 23, 2019, 05:58:57 AM »


This may be a totally stupid response as I haven't half a clue.   But........

I would think that the Vascular Surgeon could open the arm, tie off the souce and again tie off farther down the damaged vain, then strip out the damaged vein, closoing the arm and letting it heal.

Sure the access site would be gone requiring creation elsewhere.  But this should stop the swellilng and the skin spliting.

Is this not an option?      It seems to make sense to me, but then again, I am just a guy, a mechanic.   I don't get to work on people.



Apparently nobody would cut in the arm. Too many collateral veins (which are all fistulas)
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I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
       still on waitinglist, still ok I think
iolaire
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« Reply #9 on: April 23, 2019, 06:41:03 AM »

It sounds like the "Interventional radiology" part is just like when they are declotting the fistula meaning its "image-guided diagnosis and treatment"  https://en.wikipedia.org/wiki/Interventional_radiology

So the radiology has nothing to do with the actual closure but just the imaging methods so they can see the various wires and tools they put in your vein to do the work.  (When I read radiology my first thought was they going to burn the vein closed with radiation - maybe the terms are understood by others?)

They are still doing something to block the blood to the access, after some searches I can not find that exact example but I think this PDF shows some examples of them closing off veins using shunts:
https://pubs.rsna.org/doi/pdf/10.1148/rg.2016150124

My gut feeling on this is that is probalby a good method and less invasive then surgery to close off the vein, but it also might be much more detailed as they have to do all the work within the vien using the "radiology" to see what they are doing.

I'd be intrested in hearing how they explained the procudure to you?

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Transplant July 2017 from out of state deceased donor, waited three weeks the creatine to fall into expected range, dialysis December 2013 - July 2017.

Well on dialysis I traveled a lot and posted about international trips in the Dialysis: Traveling Tips and Stories section.
cassandra
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When all else fails run in circles, shout loudly

« Reply #10 on: May 13, 2019, 06:37:03 AM »

Sorry Iolaire, bit late back to you  :angel; , the vasc surgeon said: they will put some material in either the vein, or the artery at the anastomosis so the fistula stops working. I just spoke to someone at intervention radiology who’d had a look at the previous fistula grams who said : it should be poss.


That’s the best we can hope for. At the moment the pain and swelling of that arm are so bad that I’m nearly looking forward to it.


Thanx for all the research you guys and galls, and thinking you’ve all been doing!!!


Love to all, Cas
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I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
       still on waitinglist, still ok I think
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