Our team supports a full scope of dialysis procedures for patients at several dialysis centers receiving treatment for end-stage renal disease (ESRD). Whether a patient has an arteriovenous fistula, arteriovenous graft, peritoneal dialysis catheter or dialysis catheter, our specialists have proven therapies to make sure dialysis access functions safely and smoothly.
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Vein mapping is performed to work out the diameter, length and suitability of the superficial veins for placement of a dialysis access. We perform this procedure with venography using contrast dye.
Angioplasty, Stenting, and Fistula Salvage.
Stenosis may be a blockage or narrowing within the access. To open a stenosis, we may intervene with angioplasty and/or stent placement to enhance blood flow. In angioplasty, alittle balloon mounted on a catheter is inflated within the vessel , expanding the narrowed access. If necessary, we can also insert a metal stent to take care of even blood flow throughout the access. For arteriovenous (AV) fistulas that haven’t “matured” for optimal dialysis treatment, we will provide a series of angioplasty and/or stenting treatments to expand the access. A fistula salvage may be a series of access interventions performed over the course of a couple of weeks.
Thrombectomy and Thrombolysis.
For a clotted access, we provide ###i/i### to get rid of blood clots or “thrombi.” this will be wiped out a spread of the way , including:
– Medications to dissolve the clot
– Angioplasty to repair the explanation for the clotting
– Mechanical thrombectomy devices also can be wont to remove the clot
Dialysis Catheter Placement and Removal.
We offer dialysis catheter placement to offer our patients immediate access to dialysis treatment. While there are several sorts of catheters, they’re all typically flexible hollow tubes placed during a vein within the chest. A catheter could also be placed while a fistula (graft) is waiting to mature or when there’s no other dialysis access available. When a patient has received a functional hemodialysis arteriovenous fistula, or it’s matured, we’ll also safely remove the dialysis catheter.
Peritoneal Dialysis Catheter Placement and Repositioning
Peritoneal dialysis may be a process that uses the patient’s abdomen membrane lining as an access point across which fluids and dissolved substances are exchanged from the blood. Fluid is introduced through a permanent tube within the abdomen and is flushed out through regular exchanges. If it’s determined that a permanent tube is that the best dialysis method for a patient, we’ll place what’s called a peritoneal dialysis catheter.
The MILLER Procedure for Steal Syndrome
Steal syndrome may be a clinical condition caused by blood being diverted into the fistula (graft) and faraway from the hand. To correct the balance of blood flow, we provide a banding technique — the Minimally Invasive Limited Ligation Endoluminal-assisted Revision (MILLER) procedure — to accurately manipulate the access to the right size and permit for even blood flow. This procedure uses an angioplasty balloon as a sizing tool, allowing our physicians to band accesses to the right diameter to treat Steal syndrome and restore high-flow access.
A Peripherally Inserted Central Catheter (PICC) may be a long, thin plastic tube that functions as an intravenous (IV) line. A PICC line is inserted into a peripheral vein, typically within the upper arm, and advanced under ultrasound and x-ray guidance until the catheter tip reaches an outsized vein within the chest. A PICC’s central tip location within the body allows for treatment that would not be achieved with a typical peripheral IV access. additionally , PICC insertions are less invasive, have fewer complications and may remain in situ for a way longer duration than other sorts of central lines.
Implantable ports are wont to facilitate future intravenous (IV) access, for instance , to administer chemotherapy for cancer treatment. The implantable port is placed under the skin and features a small reservoir attached to a catheter, which connects to a vein. An implantable port could also be permanent, or it’s going to be removed if it’s determined the patient not requires a port for access within the near future.