At Advanced Vascular Surgery, we can perform a wide range of dialysis treatments, including arteriovenous fistulas, arteriovenous grafts, and catheters for hemodialysis. Hemodialysis is a preferred treatment for kidney failure and helps to remove waste and excess fluid from your blood. During your visit to us, our experienced staff of vascular specialists will work with you to discover the best treatment option for you. Whether you’re experiencing diabetic foot pain, leg pain, or any number of other symptoms, you can be confident that your health is in the best of hands.
A central venous catheter is a plastic tube placed in a large, central vein in the neck, chest, or groin. Most catheters are “tunneled,” going under the skin of the chest and into the vein in the neck. The part used for hemodialysis comes out through the skin of the chest. It has two pieces of tubing in a Y-shape with a cap on each end. Most catheters are temporary, for weeks or months, until a graft or fistula is ready. Some people on hemodialysis have no other options and must use a catheter all of the time. The vein used for a catheter can affect your future access options.
In other cases, a femoral catheter may be used for a short time. The catheter is placed in the femoral vein in the groin and taken out after each treatment. Since it is in the groin, a femoral catheter is hard to keep germ-free. If your doctor suggests that you have one, ask if there are other options that would work for you.
An arteriovenous fistula is made by sewing an artery to a vein, most often in your arm. Strong blood flow from the artery makes the vein grow larger. Veins are close to your skin’s surface, so a fistula can be used for hemodialysis. If the option is available to you, fistulas are the best type of access, as they last longer, need fewer repairs, and result in fewer infections and blood clots.
After surgery, it takes about four to six weeks for a fistula to mature, meaning that it can be used for hemodialysis. The doctor or nurse will decide when it is ready. Making a fist or squeezing a handgrip may send more blood to your fistula so that it works better and matures faster. For an upper arm fistula, you can achieve the same results by lifting a small two to five pound dumbbell or soup can.
A graft is made by using a piece of synthetic vein to connect an artery and vein. Arteries have the strong blood flow needed for hemodialysis and veins are located close to the skin. A graft, most often placed on the arm, allows for simpler, faster access to you blood flow. Grafts are the second best method of access, after fistulas, because grafts wear out, get infected, or get clotted much easier.
Over time, most grafts need “tune ups” in the office. Depending on the graft and how well it was cared for, it can last three years or longer. After surgery, a graft can be used for hemodialysis in about two weeks, after the swelling has gone down.