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Sunday, December 17, 2017
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Vascular Access

A vascular access is a surgically created vein used to remove and return a patient’s blood to a hemodialysis machine called a dialyzer located outside the body. The Dialyzer filters a patient’s blood through its thin fibers that removes wastes and extra fluids. A different tube is used to return the blood back to the patient. There are 3 different types of vascular access:

  • The Arteriovenous Fistula or AV fistula is a connection of an artery to a vein. The AV fistula is usually made in the forearm or upper arm. This causes the vein to grow large and strong from the extra pressure and extra blood flowing through it. This large vein allows easy access to blood vessels and allows for regular hemodialysis sessions. This type of vascular access is recommended by health care providers because it allows for good blood flow for dialysis, it lasts longer than other types of access, and is less likely to get infected or cause blood clots. Before an AV fistula is installed, the surgeon may perform a vessel mapping test to find the best blood vessels to use. The method requires an ultrasound to safely map the blood vessels of a patient and a radiologist will interpret the images created. AV fistulas require 2 to 3 months before a patient is able to use it for hemodialysis. If the AV fistula fails to develop, the surgeon will repeat the procedure. Once the patient has an AV fistula, the patient must learn to take care of the needle insertion area to prevent infections. In most circumstances, after AV fistula procedures, a patient may need to stay in a hospital overnight. 
  • The Arteriovenous Graft or AV Graft is a looped plastic tube that connects an artery to a vein. An AV Graft is performed like a AV Fistula by a vascular surgeon. A patient may need to stay overnight after the procedure and the patient will be provided a local anesthesia to numb the area where the surgeon creates the AV graft. The AV graft is usually ready to be used 2 to 3 weeks after the surgery. AV grafts usually has more problems with infection and clotting than AV fistulas. Repeated blood clots can block the flow of blood through the graft, however with care, the graft can last for several years.
  • The Venous Catheter is a tube inserted into a vein in the neck, chest, or leg near the groin. This is normally for short-term hemodialysis. If a kidney disease has progressed quickly, a patient may not have time for a placement of an AV fistula or AV graft before starting hemodialysis treatments. Patients with venous catheters are more susceptible to blood clots, infections, or a scarred vein. The Venous Catheter will work for several weeks or even months until a surgeon can perform a long-term access. Sometimes this type of access is used to treat a patient quickly while an AV fistula or AV graft is made ready. In rare cases where a fistula or a graft is unsuccessful, the surgeon will make a more long-term venous catheter access. The Nephrology Group, Inc.  has a Vascular Access Center located on the first floor of the building. Our nephrologist will refer you to the VAC if a vascular access is required.
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