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.

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.