While its a temporary measure for those with kidney issues, it can also be used as a permanent procedure for those who
are unable to have their kidney problems addressed by a professional. At Vascular Health Centers, one of the many services they
provide is dialysis and venous access at their clinic.
Dialysis is a medical treatment used in patients with an acute or chronic kidney disease (CKD). You can expect to meet with a professional to determine the best treatment plan for your body. The dialysis machine filters toxins and excess fluid from the patients blood and then returns it to the patients circulatory system. Dialysis clinics perform the job that the kidneys usually do when they are healthy.
If you have a kidney disease, then dialysis will be able to help to keep you healthy for a more permanent treatment. A vascular surgeon must create an internal vascular access to perform dialysis treatment. Vascular doctors use two types of internal vascular access at the Vascular Health Centers. These two methods are arteriovenous fistula and arteriovenous graft, which are more detailed below.
Arteriovenous Fistula
The first method of dialysis is an arteriovenous fistula. This method of venous access involves connecting a vein to a larger artery to cause the vein to distend. The fistula, or large blood vessel, makes it possible to perform dialysis with a low risk of infection. The larger blood vessel also has less risk of becoming clotted. Often, an arteriovenous fistula is created in the lower or upper arm and it allows unrestricted use of the limb.
Patients with small veins are not good candidates for this procedure.
The biggest risk to patients is that too much blood will pass through the fistula (steal syndrome).
This method is actually one of the preferred ones of vascular access because of the low risk of infection as well as the clot formation.
This method can result in longevity in comparison to other methods.
Arteriovenous Graft
The second method that we use at Vascular Health Centers is the arteriovenous graft. This method is for those patients who are unable to get the arteriovenous fistula type of vascular access. This method can have a lifespan of about two to three years, and while the increase of infection is slightly higher. It beneficial for those who have smaller veins or blocked veins.
The vascular surgeon creates an artificial vein by grafting a tubular piece of Teflon material to both a vein and an artery.
The tube will be put under the skin and the tube is punctured while you are undergoing dialysis. Like the fistula vascular process, the graft method is typically used in the upper or lower arm and it offers unrestricted movement of the grafted limb. Unlike the other procedure, arteriovenous graft carries a higher risk of clotting and infection, in addition to the risk of steal syndrome.
This procedure is generally administered for dialysis for two to six weeks.
After Arteriovenous Graft
Due to the potential risks associated with the procedure, the patient needs to take some precautions to prevent complications.
For example, you should elevate the limb used for 24 to 48 hours to reduce the swelling in your limbs. Keep the graft site dry and dont lift or drape heavy items across it. Also, dont use blood pressure readings, injections, or IV needles on the access arm.
Safe and reliable venous access should be a priority when treating dialysis patients. Every patient is different and requires a personal approach to a treatment. What may work for one person might not necessarily work for another person.
Vascular Access
Vascular access is essential for beginning dialysis whether you will receive treatment short-term, intermittently, or for the rest of your life.
The Vascular Health Centers have performed a number of minimally-invasive venous access procedures to help maintain dialysis as well.
Fistulagrams
These are studies used to monitor patients who have received either the fistula or the graft method. We use a number of indicators such as venous pressure readings, prolonged bleeding, low flow rates, and more to ensure that your dialysis access is performing efficiently.
Placement Of Temporary And Permanent Catheters
Vascular Health Centers provide the placement of temporary and permanent catheters when the need for dialysis is great. We implement a central venous access in your groin or neck that can be used temporarily. It is a good idea to have access surgery well in advance before beginning the dialysis therapy. This allows the access site to heal and reduces your risk of infection. We can provide a temporary catheter until your permanent fistula or graft has matured.
