What is Vascular Access
Hemodialysis, also called dialysis, is the most common treatment for kidney failure. A dialysis machine is an artificial kidney which cleanses the blood. During dialysis, blood is drawn from the patient into the dialysis machine, circulated through the machine, and then returned to the patient. Two needles are inserted into the patient’s bloodstream to allow this process to occur. Hemodialysis is normally performed three times a week and the purpose of vascular access is to provide reliable sites where the bloodstream can be easily accessed each time. There are three major types of vascular access: arteriovenous fistula, arteriovenous graft, and venous catheter. The great majority of vascular accesses are created in the arm, but they can also be created in the leg.
Types of Vascular Access
- Arteriovenous Fistula
- Arteriovenous Graft
- HeRO GraftHeRO
How to prepare for creation of a vascular access
In preparation for creation of a vascular access, the patient should reserve one arm which should not be used for blood draws, intravenous lines (IVs) or taking of blood pressure. The vascular surgeon may order imaging of the venous system which may include a duplex ultrasound, which is non-invasive, or a venogram. A venogram is a special type of x-ray in which contrast dye is injected into the veins, allowing a detailed picture to be taken of the veins. In general, a venogram is only needed in patients who have had many previous dialysis access procedures and the venous anatomy is unclear. The vascular surgeon and his staff will advise the patient on how long to fast prior to the procedure, and which medications to take or not take.