Hyderabad · Vascular & Endovascular Care

AV Fistula Surgery for Dialysis in Hyderabad

An arteriovenous (AV) fistula is the gold-standard, longest-lasting access for haemodialysis. Dr. Pritee Sharma creates and salvages AV fistulas — radiocephalic, brachiocephalic, brachiobasilic transposition and prosthetic AV grafts — at Renova Century Hospital, Banjara Hills.

An AV fistula joins an artery to a nearby vein under the skin so the vein enlarges and toughens over 6–8 weeks. It can then be cannulated three times a week for lifelong dialysis with the lowest infection and thrombosis rates of any access.

Careful pre-operative vein mapping by duplex ultrasound is crucial. Dr. Sharma performs the mapping herself, chooses the most distal usable site to preserve future options, and uses a magnifying loupe for precise anastomosis.

For failing or thrombosed fistulas, fistuloplasty (balloon angioplasty), thrombectomy and surgical revision are offered as day-care procedures.

Consultation

Take the next step toward healthier vessels

Book a consultation with Dr. Pritee Sharma at Renova Century Hospital, Banjara Hills.

Symptoms

Symptoms to watch for

  • Chronic kidney disease approaching dialysis
  • Difficult dialysis with a temporary catheter
  • Failing fistula — weak thrill, prolonged bleeding, high venous pressures
  • Arm swelling from central venous stenosis
Causes

Common causes & risk factors

  • Diabetic nephropathy
  • Hypertensive nephrosclerosis
  • Glomerulonephritis and chronic interstitial disease
  • Polycystic kidney disease
  • Repeated central catheter insertions damaging veins
Treatment options

How Dr. Pritee Sharma treats this condition

Radiocephalic (Brescia-Cimino) Fistula

First-choice fistula at the wrist — long lifespan, easy cannulation, preserves upper-arm veins.

Brachiocephalic Fistula

At the elbow — high flow, reliable maturation when wrist veins are inadequate.

Brachiobasilic Transposition

Two-stage procedure transposing the basilic vein to the surface — for patients with no other cephalic vein option.

AV Graft (PTFE)

Prosthetic graft used when native veins are unusable.

Fistuloplasty & Thrombectomy

Balloon angioplasty or open thrombectomy to salvage a failing/clotted fistula.

Central Venous Angioplasty

Opens subclavian or innominate stenosis causing arm swelling and fistula dysfunction.

Benefits of early diagnosis

Why early care matters

  • Longest-lasting dialysis access — often 10+ years
  • Lowest rates of infection and clotting
  • Freedom from tunnelled dialysis catheters
  • Improved dialysis adequacy and quality of life
  • Better long-term survival on dialysis
Why choose

Why choose Dr. Pritee Sharma

  • Personal duplex vein mapping by Dr. Sharma
  • Loupe-magnified precision anastomosis
  • Coordinated with nephrology for optimal timing
  • Salvage procedures for failing fistulas under one roof
FAQ

Frequently asked questions

Ideally 3–6 months before dialysis is expected — usually when eGFR falls below 20 ml/min. Early referral avoids tunnelled catheters.

It is done under local anaesthesia or a regional arm block and is essentially pain-free. Patients go home in a few hours.

A well-created radiocephalic fistula can last 10+ years. Regular monitoring and timely fistuloplasty prolong lifespan significantly.

Yes — in most cases, fistuloplasty or surgical revision can restore function, avoiding a new access site.

Recovery

What to expect during recovery

  • Day-care surgery under regional block or local anaesthesia
  • Discharge in 4–6 hours, dressing at 48 hours
  • First cannulation only after 6–8 weeks of maturation
  • Daily fistula exercises (hand-ball squeezing)
  • Duplex maturation check at 6 weeks
Hyderabad context

Why this matters in Hyderabad

  • Hyderabad's IT, BPO and corporate workforce spend 9–12 hours seated daily — a leading driver of varicose veins, DVT and venous reflux in patients under 45.
  • High prevalence of diabetes across Telangana (over 14% of urban adults) makes diabetic foot disease and PAD some of the most common limb-threatening conditions seen at Renova Century Hospital.
  • Hot, humid summers and prolonged standing in retail, teaching and healthcare further increase the burden of chronic venous insufficiency in Hyderabad and Secunderabad.
  • Patients travel to Banjara Hills for vascular care from across Telangana, Andhra Pradesh, Karnataka and Maharashtra — Dr. Sharma's team coordinates out-station travel, imaging review and cashless insurance.
About your surgeon

Dr. Pritee SharmaVascular & Endovascular Surgeon

21+ years of dedicated vascular and endovascular surgical experience.

Qualifications
  • MBBS — Topiwala National Medical College, Mumbai
  • MS (General Surgery)
  • DNB Peripheral Vascular Surgery — Gold Medalist (awarded by the Hon'ble Ex Vice President of India)
  • Fellowship in Endovascular Surgery
Hospital affiliations
  • Head of Department, Vascular & Endovascular Surgery — Renova Century Hospital, Banjara Hills, Hyderabad
  • Former Consultant — Army Hospital Research & Referral, Delhi
  • Member — Vascular Society of India (VSI)
  • Member — Indian Association of Cardiovascular & Thoracic Surgeons
Consultation

Concerned about av fistula for dialysis?

Get a personalised assessment and treatment plan from Dr. Pritee Sharma.