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Intra-Operative

Complication	Description of Complication	Potential Ways to Reduce Risk
Haemorrhage	This can occur due to damage to either the artery or the vein or leak from the anastomosis, which can require a blood transfusion.
Injury to Surrounding Structures	All dependent on the specific location of the fistula
Anaesthetic Risks	Includes damage to the teeth, throat and larynx, reaction to medications, nausea and vomiting, cardiovascular and respiratory complications.	Forms a part of the anaesthetist assessment before the operation

Early

Complication	Description of Complication	Potential Ways to Reduce Risk
Pain	There is typically minimal pain experienced following this procedure.
Bleeding	There is a small chance of bleeding and bruising in the fistula site post-surgery.
Infection	Superficial wound infection is possible, although rare in this case.	Peri-operative antibiotics will reduce the risk of wound and graft infections
Scarring	This procedure will result in a scar, which can form as a keloid scar.
Seroma	A swelling of lymphatic fluid may occur due to disruption of the lymph nodes and channels.	Careful dissection of the lymphatic nodes and channels with ligation will minimise this risk.
Blood Clots	DVTs and PEs are a possibility in any operation. The risk is increased in patients with a raised BMI, on the pill, recent flights, previous DVT, pregnancy, smokers, cancer and prolonged bed rest.	The patient will be given anti-embolism stocking and low molecular weight heparin peri-operatively to minimise this risk as deemed appropriate.
Failure to Mature	This occurs in approximately 20% of cases, whereby the fistula will not form fully and not function.	Ensuring optimum arterial and venous diameters, no additional vascular disease, and a meticulous technique.
Steal Syndrome	This is where too much blood travels through the fistula resulting in an ischaemia in the hand, as distal to the fistula. This may requiring tightening of the fistula, an alternative procedure, or removal of the fistula entirely.
Stroke, MI, Kidney Failure, Death	Although small, this is always a risk in any major surgery.

Late

Complication	Description of Complication	Potential Ways to Reduce Risk
Reintervention	Occasionally fistulas will become narrowed, occlude, fail to mature, or result in steal syndrome, each requiring their own treatment.

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