Dialysis Access Program

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VasCare’s Dialysis Access Program

VasCare’s dialysis access program is designed to provide comprehensive access care for End-Stage Renal Disease (ESRD) patients.  Recognizing the most critical components of a best-in-class program are high-quality creation and management procedures, VasCare’s Corpus Christi Clinic has assembled a multidisciplinary team of specialists to provide world-class care to patients in our community.

Our program optimizes access by offering a full complement of premium treatment services such as surgical creations, catheter placement and removal, fistulagrams, thrombectomy, angioplasty and stenting, and fistula maturation. By ensuring efficient blood flow for dialysis treatments, Vascare reduces complications, enhances outcomes and improves quality of life for individuals managing ESRD.

What is an AV Fistula?

An AV fistula is a connection that’s made between an artery and a vein for dialysis access. A surgical procedure, done in the operating room, is required to stitch together two vessels to create an AV fistula.

AV Fistula (1)
AV GRAFT PLACEMENT (1)

Dialysis Access Graft

A dialysis access graft, also known as an arteriovenous (AV) graft, is a type of access point that allows a dialysis machine to connect to a patient’s blood vessels. During the procedure, a surgeon uses a synthetic fabric graft to connect an artery and a large vein in the patient’s arm, leg, or chest wall. The graft is woven into a watertight tube that’s usually U-shaped and placed under the skin.

Hemodialysis Catheter

The procedure involves creating a tunnel under the skin to thread the catheter. The catheter has a cuff under the skin to help keep the catheter in place, prevent infection and allow the catheter to remain in for an extended period of time. A hemodialysis catheter is a flexible tube used for dialysis treatment. The catheter is placed into the blood vessel in your neck or upper chest and is threaded to the right side of the heart. The catheter has two tubes inside, one to take blood to the dialysis machine the other to return the blood.

Hemodialysis Catheter

Access Warning Signs

A functioning Vascular Access is vital for Dialysis. Here are some warning signs your access may be failing:

Pain

If you experience unusual pain at the access site, it could be a sign that your access is failing.

Poor Catheter Flow

A flow rate of less than 300 ml/min indicates poor catheter function and may suggest an impending failure.

Redness/Drainage

Redness or drainage around the access site can signal an infection or other issues that could compromise catheter performance.

Poor Clearance

Inadequate clearance during dialysis sessions can be a warning sign malfunction.

Clotting of Lines

Frequent clotting in the catheter lines can indicate that your access is not functioning properly.

Recirculation

High levels of recirculation during dialysis may suggest that your access is not effectively delivering blood flow.

Unable to Aspirate

Difficulty or inability to aspirate blood from the catheter is a strong indicator that it may be failing.

Dialysis Access Treatment

VasCare offers both access creation and access management services for ESRD patients:

Vein Mapping

Vein mapping of arm vessels is a crucial step before the surgical creation of dialysis access. It has been proven to significantly increase the success rates of arteriovenous fistulas (AVFs).

This procedure is performed in-office using ultrasound technology and is completely painless.

Catheter Placement, Exchange or Removal

A hemodialysis catheter is a hollow tube used for importing and exporting blood from the body. These can be either tunneled or non-tunneled, with tunneled catheters being used for longer-term access.

 

Fistulogram

This is a minimally invasive procedure in which a small tube known as a sheath is inserted into the fistula. Through this sheath, we are able to administer sedative medication and perform diagnostic and therapeutic interventions.

 

Thrombectomy/Declot

If your access clots, a procedure similar to a Fistulogram is performed to remove the clot and restore adequate flow in your fistula/graft

Fistula Maturation

Once a fistula is created, it usually takes about 2 months before the fistula is ready for dialysis. If the fistula is slow to mature, a fistulogram is done to identify and treat the cause.

VasCare Benefits to Treating ESRD

Faster Recovery

Minimally invasive treatments typically result in quicker recovery times compared to traditional surgeries, allowing individuals to return to their daily activities sooner.

Reduced Risk of Complications

Minimally invasive procedures are associated with lower risks of complications such as infection and excessive bleeding, enhancing overall safety for ESRD patients.

Preservation of Access Site

These procedures aim to preserve the functionality of the access site, ensuring continued effectiveness of dialysis treatments without the need for extensive surgical interventions.

Improved Quality of Life

By effectively addressing access issues with minimally invasive techniques, individuals with ESRD can experience improved quality of life, including reduced pain and discomfort associated with dysfunctional accesses, and better overall health outcomes.

Schedule Your Consultation With Our Dialysis Doctors

Dr. Llewellyn Lee – Board-certified Vascular & Interventional Radiologist

Corpus Christi, Texas
In his more than two decades practicing medicine, Dr. Llewellyn Lee has become an authority on vascular and interventional treatments with thousands of successful procedures performed.

Dr. Jennifer Mike-Mayer – Board-certified Vascular Surgeon

Corpus Christi, Texas
With expertise in vascular surgery and a commitment to excellence, Dr. Jennifer Mike-Mayer has become a leading authority in vascular surgical procedures, successfully treating thousands of patients.

What to expect at a Dialysis Access procedure?

Before the Procedure

Patients can expect a thorough pre-procedure consultation with our multidisciplinary team of specialists. This session ensures that every aspect of the patient’s health and treatment plan is considered to optimize outcomes and minimize risks.

During the Procedure

Our skilled professionals utilize advanced techniques for catheter placements, fistulagrams, and other procedures. The goal is to ensure efficient blood flow, reduce complications, and enhance the effectiveness of dialysis treatments.

After the Procedure

Post-procedure care includes monitoring and managing the access site to ensure proper healing and functionality. Our team provides ongoing support and follow-up to address any concerns and to maintain the access site for long-term use.

What Our Patients Are Saying

Dialysis Access Program FAQs

What is Dialysis Access, and why is it important?

Dialysis access is a surgically created site on your body where blood is removed and returned during hemodialysis. It is crucial because effective dialysis access ensures efficient blood flow for dialysis treatments, reducing complications and enhancing patient outcomes.

What types of dialysis access are available at VasCare?

VasCare offers a range of dialysis access options, including arteriovenous (AV) fistula creations, catheter placements and removals, and AV grafts. Our team evaluates each patient to determine the most suitable type of access.

How is an AV fistula created?

An AV fistula is created by surgically connecting an artery to a vein, usually in the arm. This procedure is performed in the operating room and results in a strong blood vessel that can handle repeated needle insertions for dialysis.

What is the fistulagram, and why is it necessary?

A fistulagram is a diagnostic procedure that evaluates the function and structure of an AV fistula. It involves inserting a small tube into the fistula to administer sedative medication and perform diagnostic and therapeutic interventions, helping to identify and treat any issues.

What are the warning signs that my dialysis access might be failing?

Warning signs include pain at the catheter site, poor catheter flow (less than 300 ml/min), redness or drainage, inadequate clearance during dialysis, frequent clotting in the catheter lines, high levels of recirculation, and difficulty or inability to aspirate blood from the catheter.

How long does it take for an AV Fistula to mature?

Typically, an AV fistula takes about two months to mature and be ready for dialysis. If the fistula is slow to mature, a fistulagram may be performed to identify and treat the cause.

What is vein mapping, and how does it help in dialysis access creation?

Vein mapping involves using ultrasound technology to visualize the arm vessels before the surgical creation of dialysis access. This painless, in-office procedure significantly increases the success rates of arteriovenous fistulas (AVFs).

What is Thrombectomy and when is it performed?

Thrombectomy is a procedure to remove blood clots that can occur in the access site. It is usually performed under imaging guidance and is essential for patients experiencing acute ischemic stroke, deep vein thrombosis (DVT), or peripheral artery disease.

What post-procedure care is provided after dialysis access creation?

After the procedure, our team monitors and manages the access site to ensure proper healing and functionality. We provide ongoing support and follow-up care to address any concerns and maintain the access site for long-term use.

What benefits does VasCare's Dialysis Access program offer to ESRD patients?

VasCare’s program offers faster recovery times, reduced risk of complications, preservation of access sites, and improved quality of life through minimally invasive techniques. Our comprehensive care ensures optimal outcomes and enhances the overall health of ESRD patients.