Safer, Simpler & Affordable Solution for High-Flow AV Fistulae in Nephrology Care
In a significant breakthrough for dialysis patient care, the Department of Nephrology at PGIMER has introduced a pioneering solution to address high-flow AV fistulae complications—an issue affecting a large number of patients. This innovative banding technique, designed as a safe, simple, and affordable day-care procedure, provides an effective alternative to traditional treatments and marks a major advancement in nephrology care.
Prof. Vivek Lal, Director PGIMER, stated, “This ground-breaking approach exemplifies how tailored, cost-effective solutions can revolutionize 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.”
Underpinning the affordability and cost effectiveness of the technique Prof. H S Kohli, Head, Department of Nephrology, 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.”
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, hospitalization, and expensive equipment like catheterization labs, often costing around 50,000 rupees—posing a financial burden on patients and healthcare systems alike.
Recognizing this challenge, PGIMER team led by Prof. Manish Rathi from Department of Nephrology and ably supported by Dr Ajay Salwania from Department of General Surgery , developed a simple yet effective banding technique that can be performed without the need for advanced imaging or hospitalization.
Detailing about the technique, Prof. Manish Rathi shared, “Over the past three years, we have successfully carried out this procedure for numerous patients, gaining the world’s largest experience with this approach. The 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.”
Prof. Rathi further detailed, “This breakthrough method offers multiple benefits. The entire procedure costs approximately 5,000 rupees 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 catheterization 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. 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.”
“Our pioneering work has been recognized internationally. We presented our findings at a prominent national conference in Delhi, showcasing the largest body of experience with this technique worldwide. The significance and innovation of our work were further acknowledged when we received the prestigious Best Paper Award two years ago, highlighting our contribution to advancing nephrology care,” further added Prof. Rathi.
“This development marks a major leap forward in managing high-flow fistula complications, offering a safe, affordable, and effective solution. It empowers us, the healthcare providers, to improve patient outcomes while reducing treatment costs and risks associated with traditional procedures.”
“Our team remains committed to enhancing dialysis patient care through ongoing research and innovation. We plan to continue refining this technique and expanding its availability, ensuring that more patients benefit from this life-changing procedure,” concluded Prof. Rathi.
