Hemodialysis Vascular Access
Undergoing chronic hemodialysis requires an easy access to the patient's blood stream, via one of the following ways:
- Through the patient's own blood vessels (called an arteriovenous fistula),
- Inserting a tube made from synthetic material that links an artery and a vein under the skin (a PTFE graft)
- Via a catheter inserted directly in a vein (a venous catheter).
The right hemodialysis vascular access must be individualized for each patient.
A vascular access is created by a surgeon in an operating room. Patients usually are given a local or general anesthesia. The vascular access (fistula or graft) is usually placed in the arm and often requires several weeks or months to heal and be ready for use. The vascular access may be noticeable to other people. This vascular access is the patient's "life line" and special care is necessary to make sure that it continues to function properly. A catheter is usually placed in the neck and may be placed by a vascular surgeon or an interventional radiologist.
Mayo Clinic's vascular surgeons are skilled and experienced in creating all types of vascular access and are leaders in vascular access innovation. Mayo's interventional radiologist are experts in imaging and declotting and opening the vascular access. Interventional radiologists also insert dialysis catheters. Mayo's vascular surgeons, interventional radiologists and nephrologists work together to provide quality access care to our patients.
Mayo Clinic dialysis patients are routinely checked to make sure their hemodialysis access (arteriovenous fistula or PTFE graft) is working properly. This surveillance helps minimize unexpected malfunctions or clotting. Vascular surgeons and interventional radiologists are available to help insert new hemodialysis access devices, revise old access devices to maintain their function and help to declot and repair fistulas and/or PTFE grafts when they clot or become infected.
Peritoneal Dialysis Catheter
Peritoneal dialysis catheters are inserted by a Mayo Clinic vascular surgeon about one month before they will be used. Patients usually receive general anesthesia, but local anesthesia is occasionally used. Surgeons are also available to help revise peritoneal dialysis catheters that are not functioning properly or have become infected.