Our Vascular Centers provide many services for patients needing dialysis. Each of our Access Centers is committed to providing you with the latest in state of the art imaging, diagnostic and interventional services, and education to meet your dialysis access needs. We will partner with you and your Nephrology care team to develop a plan of care surrounding your vascular access needs. Our endovascular experts will put you on a schedule to monitor your access and intervene as medically necessary. Our goal as your endovascular center of excellence is to maintain, preserve and/or restore your access so you can enjoy a happier and healthier lifestyle.
In order to provide the best dialysis access services to you, there are several procedures your Vascular Access experts can utilize:
Fistulagrams are studies performed to assess the function of the fistula or graft. Several clinical indicators are used to determine the frequency of these studies such as high venous pressures, low flow rates, prolonged bleeding, difficulty with cannulation, weak thrill or bruit or pulsatile site. When you are experiencing difficulty with your access during your dialysis session, performing a fistulagram allows your physician visibility of the issue.
Often times a study will indicate the presence of a narrowed area (stenosis) in the outflow vein or the inflow artery. When this occurs it is necessary to place a balloon catheter across the narrowed area and dilate that stenosis to prevent the graft from blocking (clot).
Many times a narrowed vessel will not respond to a balloon procedure alone. When this happens, we have a secondary option of placing a metallic device called a ‘stent’ across the narrowed area, using the balloon to open the stent and keep the narrowed area open.
If your surgeon places a fistula, or surgically created pathway, in your arm, this process can take time until it is ready to use. This waiting period is often called “fistula maturation.”
If a fistula does not mature properly, Vascular Access Centers’ interventionalists can use an x-ray dye to “see” if we can find a reason why the maturation did not occur. After this process, we can then use our minimally invasive techniques to assist in the fistula maturation process by re-routing or re-directing the blood flow into the fistula.
Even under the best of care, it is possible for your access to be blocked for various reasons.
Once your dialysis center has determined that your access has clotted, the nearest Vascular Access Center can set you up for a Thrombolysis procedure to “de-clot” your access. This procedure will allow us to get into your access site, find out why it shut down, treat the problems and restore the function.
We can also treat your catheter if it is blocked from a blood or fibrin deposit using medication to dissolve the blood or fibrin, mechanically removing the clot or by changing the catheter.
At Vascular Access Centers, we can place PICC lines, both single and dual lumen, Tesio Catheters, Hickman Catheters, as well as quickly replace /repair existing catheters when there is a problem.
There are times when your need for dialysis is more important than fixing your fistula or graft.
When your need for dialysis is immediate, we offer a central venous access for temporary use. During this procedure we will place a catheter in your neck or groin using ultrasound guidance.
Ultrasound can show us the best place to put a catheter without having to try several times, so that we can facilitate a quick and easy method of temporary central venous access for your dialysis.
At Vascular Access Centers, we place central venous access catheters in your arm or chest for your long term needs. These types of central venous catheters (Chest and Arm Ports) can be used for antibiotics, chemotherapy, and nutritional support. The advantage of these types of catheters is that they are placed under the skin and not easily detectable.
When you are new to dialysis you may need to be dialyzed with a catheter until your fistula or graft is ready to use. At Vascular Access Centers, we can place this type of catheter across your collarbone so that you have access to the dialysis you need until your fistula or graft is ready for use.
Tunneled catheters may also be used for nutritional support for Total Parenteral Nutrition (TPN), Peripheral Parenteral Nutrition (PPN), and for patients needing central venous access for Chemotherapy.
Vessel mapping involves placing a small IV in your hand to inject an IV contrast (Dye). This dye will show us where your veins are. This helps our team of dialysis access experts, your Nephrologist and your surgeon plan where best to place to your fistula or graft.
For more information about how VAC can help you