Doctors come up with low-cost solution for high-flow fistula complications for dialysis patients

Chandigarh, Aug 26 (PTI) A minimally invasive and affordable banding technique to address arterio-venous fistulae complication in dialysis patients has been developed by the Postgraduate Institute of Medical Education and Research (PGIMER) here. This innovative banding technique, performed as a day-care procedure, offers a safe, effective, and affordable alternative to traditional treatments, marking a major advancement in nephrology care, the PGIMER said in a statement here.

While managing such high-flow fistulae costs around Rs 50,000, the new method costs approximately Rs 5,000, making it accessible to a broader patient population.

"This ground-breaking approach exemplifies how tailored, cost-effective solutions can revolutionise patient management, especially in resource-limited settings like ours. We are proud to lead in this field and improve the quality of life for our dialysis patients," Prof Vivek Lal, director PGIMER, said on Tuesday.

Emphasising the affordability of the technique, Prof H S Kohli, Head of the Department of Nephrology at PGIMER, said, "The development of this technique has been a game-changer." It provides a safe, simple, and affordable option for managing high-flow arterio-venous fistulae, directly addressing a major complication in dialysis care, Prof Kohli added.

High-flow fistulae are a common complication among dialysis patients. These fistulae, which are surgically created connections between an artery and a vein, are vital for effective dialysis.

However, when the fistula's flow rate becomes excessive, it can lead to increased pressure on the heart, resulting in heart failure, inadequate dialysis, and risks of fistula rupture.

Until now, managing such high-flow fistulae required complex procedures involving angiography, hospitalisation, and expensive equipment like catheterisation labs, often costing around Rs 50,000, posing a financial burden on patients and healthcare systems alike, the statement said.

A team led by Prof Manish Rathi from the Department of Nephrology and supported by Dr Ajay Salwania from the Department of General Surgery, developed a simple yet effective banding technique that can be performed without the need for advanced imaging or hospitalisation, it added.

Prof Manish Rathi said, "Over the past three years, we have successfully carried out this procedure for numerous patients, gaining the world's largest experience with this approach." This procedure involves placing a controlled constriction on the fistula to reduce its flow, thereby alleviating cardiac strain and preventing further complications. It is performed as a day-care procedure, requiring no anaesthesia in most cases, and can be completed within a short outpatient visit, he added.

Prof Rathi further said, "This breakthrough method offers multiple benefits. The entire procedure costs approximately Rs 5,000 as compared to Rs 50,000 otherwise with traditional procedures, making it accessible to a broader patient population".

It is minimally invasive, eliminating the need for angiography or catheterisation labs, which reduces risk and shortens recovery time. Being a day-care procedure, patients can return home the same day, significantly enhancing convenience and reducing hospital stay, he added.

"Our extensive experience and data have demonstrated high success rates, with sustained improvements in fistula function and cardiac health, providing a new lease on life for many patients suffering from high-flow fistula complications," the professor said.

"Our work has been recognised internationally and we have also presented our findings at a national conference in Delhi, showcasing the largest body of experience with this technique worldwide..", the professor added.

Prof Rathi also said this development marks a major leap forward in managing high-flow fistula complications, offering a safe, affordable, and effective solution, while empowering the healthcare providers to improve patient outcomes while reducing treatment costs and risks associated with traditional procedures. PTI SUN APL APL DV DV