Vascular Access Intervention
Vascular Access Intervention for Dialysis Patients
What is it?
The first step for preparing for dialysis is preparing a vascular access; the access site is the site where blood is removed and later returned during dialysis. Dialysis is a supportive treatment used to replace kidney function in patients with severe kidney damage. Dialysis removes toxic substances that accumulate in the body when kidneys fail to cleanse the blood.
Vascular specialists at The Vascular Center offer the most advanced access, maximizing the amount of blood cleansed during treatment.
Causes, Symptoms and Risk Factors
Dialysis is needed by persons who have either acute or chronic injury to their kidneys. Acute kidney injury may develop when a person suddenly develops a severe illness. Chronic kidney injury typically occurs from diabetes or high blood pressure.
Dialysis, in some instances, may be needed temporarily as kidney function improves. When kidney problems are not resolved, maintenance dialysis becomes necessary. In these cases, patients are on dialysis for the rest of their lives or until they receive a kidney transplant.
Vascular specialists at The Vascular Center perform several types of access interventions for dialysis patients, including the arteriovenous (AV) fistula, an AV graft or the venous catheter.
Arteriovenous (AV) Fistula
An AV fistula is created in the Operating Room by connecting an artery directly to a vein, most commonly in the forearm; this causes the vein to grow larger and stronger, making repeated insertions for dialysis treatments easier. It takes several months for fistulas to develop, so advanced planning prior to dialysis is recommended.
The AV fistula is considered the most effective option for patients who require long-term maintenance dialysis since it provides adequate blood flow, it lasts a long time, and it has lower complication rates than other types of vascular access interventions.
Patients who are not candidates for an AV fistula because of small, weak veins that will not develop may benefit from an arteriovenous graft. In this instance, a synthetic tube, or graft, is implanted in the Operating Room under the skin of the arm forming an artificial vein that can be accessed during dialysis treatment.
Patients who require immediate dialysis treatment can use a venous catheter as a temporary access. A catheter tube is inserted in the Endovascular Suite into a large vein in the neck, chest or near the groin. Catheters are often used while fistulas or grafts are being created for permanent dialysis access. Long-term use of catheters is avoided to reduce the chance of blood clots and infections.
Most dialysis accesses will require some follow-up treatments to maintain good blood flow. The Vascular Specialists at The Vascular Center bring their extensive experience, working together to provide the most appropriate and efficient treatment for dialysis patients.