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Vascular Surgery

Vascular surgery on fistula arm

07/11/2007

Question:

I had a kidney transplant on 5/04. My fistula arm had 3 aneurysms on the vein-the biggest measuring about 7cm. I had surgery on my upper arm (above the elbow) to remove them on 6/13/07--a plastic tube was put in to replace the vein and to retain my fistula. Surgery was performed because my vascular doctor was concerned about the high blood flow that might enlarge my heart. (I initially contacted him because my arm swelled up by my wrist area.) After surgery my arm was quite swollen (about double its original size)and after a few days it was oozing clear to yellowish fluid from some of the stitch sites. At my follow-up appointment, my arm still double its size, the stitches were removed and about 2 days later the oozing stopped. My arm is still swollen but now it feels hard. The swelling has not subsided at all in fact the swelling goes down to my hand. The swelling may subside a little bit but with any activity it will blow up again especially my hand. When the arm was oozing the arm was softer and I could massage the fluid in the arm but now it feels solid. The arm is not red or painful maybe just a little tender. I do try and elevate my arm whenever I am sitting down. Is this normal and how long will the sweling continue? Is there anything else I should be doing? Any advice would be helpful. I am scheduled for another follow in 2 weeks.

Answer:

You might want to ask your surgeon if the "venous outflow" is OK and not blocked. Often times when the connection between the artery and vein is made, more blood goes into the veins than otherwise would. If the veins can not handle all that extra blood, then a back-up occurs and swelling starts. Hope this helps. Keep elevating as you can, but you may need to have your veins in the collar bone and chest area better evaluated.

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Response by:

Amy B Reed, MD Amy B Reed, MD
No longer associated