Docs insert needle through thigh to treat blockage in dialysis

In a breakthrough in dialysis technique, a team of doctors at a city hospital inserted a special needle through a patient's right thigh to reach her heart and from there created a channel in veins of right arm to ensure passage of blood.
Rama Devi's case, which has recently been acknowledged by a reputed international medical journal, brings a ray of hope for many dialysis patients with blockage of dialysis fistula.
Fistulas are created surgically for dialysis in people with severe kidney disease.
"Rama Devi's left arm fistula was already blocked, while the right arm one was badly swollen and had 100 per cent blockage in right upper body main vein which made her dialysis difficult day by day.

"It was great challenge to create a channel between blocked vein in the right arm and heart to save the patient's arm and to protect the only working dialysis fistula. She was high risk for any surgical procedure," said Dr Amit Malik, Senior Cardiologist at BLK Super Speciality Hospital.
"We planned to do angioplasty of the blocked vein, but the site of blockage was very near to heart and right lung and there was very high risk of injury to these vital organs.

"A specially designed long needle (Trans Septal Needle) was inserted to form a vein in right thigh which reaches up to heart and a channel was created between heart and blocked right arm vein. This channel was dilated with special balloons and special stent was placed in new channel to keep it open," said Dr Malik.

The team has been monitoring 52-year-old Rama Devi, who is doing well now. The surgery which took place on October 10 last year was acknowledged and published at the prestigious international journal 'Cardiovascular Intervention and Therapeutics' recently.
It was 150-minute surgery done under local anaesthesia and patient was awake during the entire procedure.
"Within 24 hours after the procedure, her arm's swelling subsided and she underwent dialysis without any difficulty. Patient was discharged 48 hours after the procedure. Many dialysis patients with blockages in fistula arm will get benefit with this technique," said Dr Sunil Prakash, Head of Department of Nephrology at the hospital.