Preoperative Vascular Mapping & Patient Assessment
Every patient undergoes detailed preoperative evaluation including duplex ultrasound mapping of arteries and veins, assessment of vessel diameter, flow characteristics, and anatomical suitability. We consider comorbid conditions such as diabetes, peripheral vascular disease, cardiac function, and previous access history to determine the most appropriate fistula type and location, ensuring the highest chance of long-term success.
AV Fistula Creation Using Proven Surgical Techniques
We perform various types of AV fistulas including radiocephalic (wrist), brachiocephalic (elbow), and brachiobasilic fistulas with vein transposition when required. Surgical planning prioritizes native vessel preservation, optimal blood flow, and minimal tissue trauma. Our approach focuses on creating fistulas that mature reliably and can be safely cannulated for dialysis.
Fistula Maturation, Surveillance & Salvage
Postoperative care includes structured follow-up to monitor fistula maturation through clinical examination and ultrasound assessment. We identify and address issues such as stenosis, poor maturation, or low flow early using endovascular interventions like angioplasty or surgical revision, significantly reducing fistula failure rates and avoiding unnecessary catheter dependence.
Long-Term Access Care & Complication Management
We provide comprehensive long-term care for AV fistulas, managing complications such as thrombosis, aneurysm formation, steal syndrome, venous hypertension, and access-related infections. Patient education plays a vital role, with guidance on daily fistula care, recognizing warning signs, and protecting access from injury or improper use.
- Comprehensive vascular mapping and access planning
- Creation of native AV fistulas as first-line dialysis access
- Structured post-operative monitoring and maturation support
- Early detection and treatment of access-related complications
- Endovascular and surgical fistula salvage procedures
- Education on fistula care, hygiene, and protection
- Coordination with nephrologists and dialysis centers
- Long-term preservation of vascular access options
AV fistulas have the lowest risk of infection and clotting, provide better blood flow for efficient dialysis, last longer than grafts, and are associated with improved patient survival. International and Indian nephrology guidelines recommend AV fistulas as the first choice for long-term hemodialysis whenever possible.
Most AV fistulas require 6 to 12 weeks to mature adequately before they can be safely used for dialysis. During this period, the vein enlarges and strengthens to tolerate repeated needle access. Regular follow-up helps ensure timely maturation and early correction of any issues.
Potential complications include delayed maturation, narrowing of the vein (stenosis), clotting (thrombosis), aneurysm formation, hand ischemia (steal syndrome), and infection. With regular monitoring and timely intervention, most complications can be effectively managed while preserving the fistula.
Yes. Many fistula-related problems such as narrowing or reduced blood flow can be treated using minimally invasive endovascular procedures like balloon angioplasty. Surgical revision is reserved for cases where non-surgical methods are insufficient.
Patients should keep the fistula clean, avoid blood pressure measurements or injections in the access arm, check daily for the vibration (thrill), avoid tight clothing or sleeping on the access arm, and report any pain, swelling, redness, or loss of thrill immediately. Proper care significantly prolongs fistula life.
Our Team
Meet the Experts Behind Your Care
Dr. Viswanath Atreyapurapu
Consultant Vascular & Endovascular Surgeon
Dr. Manikanth Karumuri
Consultant Plastic, Reconstructive & Cosmetic SurgeonTestimonials
What Our Patients Are Saying
“I recently underwent vein laser treatment at IKIGAI under the care of Dr. Vishvanath Atreyapuram, and I am incredibly impressed with the experience and results. From the moment I stepped into the clinic, the staff made me feel welcome and at ease. Dr. Vishvanath is not only highly skilled and professional but also took the time to explain the procedure in detail, addressing all my concerns patiently.”
“My daughter was born with cleft palate and was advised to get operated after she turns 1 year old. We have lost all our hopes and were very worried about her. Dr K. Manikanth garu has done palatoplasty for my daughter last year. Since then he has taken very good care of my daughter even after the surgery and during reviews also, and now my daughter is perfectly alright. Thanks alot for Dr. Manikanth garu for the treatment.”
“Ikigai clinics is offering expert surgical care for all vascular and plastic surgery related conditions. It offers a serene ambience, world class infrastructure and highly skilled surgeons with personalized treatment plan for every patient. Highly recommended👍”
“I recently underwent vein laser treatment at IKIGAI under the care of Dr. Vishvanath Atreyapuram, and I am incredibly impressed with the experience and results. From the moment I stepped into the clinic, the staff made me feel welcome and at ease. Dr. Vishvanath is not only highly skilled and professional but also took the time to explain the procedure in detail, addressing all my concerns patiently.”
“I had a great experince with Dr viswanath Atreya and Dr manikanth karumuri for my varicose veins and venous ulcers treatment at ikigai clinics. From the very first consultation ,the doctor was kind ,through and extremely knowledgeable .iam so greatful for the care i recived and would highly recommend Dr viswanath and Dr manikanth to anyone dealing with varicose veins and venous ulcers Thank you ikigai clinics”
“⭐⭐⭐⭐⭐ Highly Recommend Ikigai Clinic for Nose Plastic Surgery! I recently had a nose plastic surgery at Ikigai Clinic, The entire experience, from consultation to post-surgery care, was handled with utmost professionalism and expertise. I'm truly satisfied with my results, and I highly recommend Ikigai Clinic to anyone considering cosmetic procedures. Thank you so much (Dr.Manikanth Karumuri)”
“I recently underwent AVF surgery with Dr. Viswanath Atreyapurapu at Ikigai Clinics, and I couldn’t be more satisfied with the care I received. Dr. Viswanath was incredibly professional, patient, and knowledgeable. He took the time to explain the procedure thoroughly and made me feel at ease every step of the way. The surgery went smoothly, and the post-operative care was excellent. Highly recommend Dr. Viswanath and Ikigai Clinics to anyone in need of vascular care.”