Dialysis Access Care
At EndoVascular Health Services we provide several different dialysis access services. Each location 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 work with you and your Nephrology care team to develop a plan of care surrounding your vascular access needs. Our goal as your EndoVascular Services is to maintain, preserve and/or restore your access so you can enjoy a happier and healthier lifestyle.
All of the different types of dialysis Procedures:
In order to provide the best dialysis access services to you, there are several procedures our EndoVascular 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 a pulsatile site. When you are experiencing difficulty with your access during your dialysis session, performing a fistulagram provides your physician visibility of the issue.
Percutaneous AV Fistula Creations
Previously, fistula creations were only performed in the hospital setting in open surgery. Now these procedures can be performed in the outpatient setting.
Percutaneous fistula creation is a minimally invasive procedure that requires only regional or local anesthesia with a procedure time of less than 30 minutes. Additionally, because the procedure uses an EndoVascular approach, it leaves the vasculature and tissue around the AV fistula undisturbed; therefore improving healing time and overall outcomes. The patient will be left with one or two small puncture sites as opposed to a lengthy scar common with traditional surgical fistula creation.
Arterial and Venous Angioplasties
Often, 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. This will dilate the stenosis to prevent the graft from becoming blocked (clotting).
Arterial and Venous Stenting
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.
Fistula Maturation Procedures
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 doesn’t mature properly, Interventionalists at EndoVascular Health Services can use x-ray dye to visualize the cause for delayed maturation. After this process, we can 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 become blocked (clotted), and this occurs for various reasons.
Once your dialysis center has determined that your access has clotted, the nearest center can refer you to EndoVascular Health Services for a Thrombolysis procedure to “de-clot” your access. This procedure will allow us to get into your access site, determine the cause of the blockage, treat the problem, 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 by mechanically removing the clot or by changing the catheter.
Complete Catheter Services
CENTRAL VENOUS catheter PLACEMENT FOR TEMPORARY USE (Hemodialysis)
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.
TUNNELED CATHETER PLACEMENT FOR HEMODIALYSIS
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 EndoVascular Health Services, we can place this type of catheter near your collarbone so that you can get the dialysis you need until your fistula or graft is ready for use.
If you currently have a tunneled catheter that is not functioning properly, we can perform a tunneled catheter exchange.
EndoVascular Health Services can also perform catheter removals for temporary and tunneled catheters. Whether you had your catheter inserted at our location or a different location we can remove it when your Nephrologist says it is time.
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.