Hemodialysis

This is a temporary option for hemodialysis, where Hemodialysis (HD) catheters serve as temporary access points. They provide direct access to the bloodstream and have a high infection rate, which is why they are used as a temporary solution. The ultimate goal is for our patients to eventually have long-term safer access like an AV fistula/graft or a peritoneal catheter, HD catheters are only placed when a patient is yet to have permanent access or when the permanent access is being fixed or has stopped working.

SURGICAL PD CATHETER PLACEMENT

PD catheter surgery is considered a minor operation for most patients and complications are often rare. Catheter placement can be done under general anesthesia and usually takes less than one hour. Most people are able to go home the same day. Surgery is typically performed by a surgeon at a hospital, but there are some kidney doctors (nephrologists) and radiologists who are also trained to place PD catheters.

PERCUTANEOUS PD CATHETER PLACEMENT

Many vascular access centers perform percutaneous catheter placement, which is far less invasive than surgery. Percutaneous catheter placement is performed using an imaging technique (called fluoroscopy) that uses X-rays to help your vascular specialist view the inside of your abdomen. This procedure requires only local anesthesia and sedation, no general anesthesia is used. You get to go home the same day. 

Your vascular surgeon begins by using a fine needle to make a series of small punctures in your skin to access the peritoneum. The PD catheter is then passed through a small tunnel in your belly into the peritoneum & secured in place.

Fistula creation starts with a vein mapping ultrasound, where you undergo a physical examination along with ultrasound diagnostics. These tests determine whether your arteries are sufficiently healthy to support a fistula. An angiogram can also be used to gauge the size and depth of your veins and arteries. If you pass the tests and are judged to be a candidate for a fistula or graft, then an appointment is made for a fistula or graft creation at your local hospital. Our vascular surgeon will perform the procedure at the hospital and follow up with your care at our private clinic. 

The actual process starts with a specialist administering local anesthesia on the identified access site. The surgeon then makes an incision that gives access to the blood vessels, a surgical connection between a vein and an artery are made. For a graft, a connection is made using a synthetic tube instead of your actual vein and artery. As a result of the connection, blood flows from the artery to the vein, which increases the blood flow, the vein enlarges, and its walls thicken.

After its creation, the AV fistula or graft is given weeks to months in some cases to mature to the point where it can be used safely for hemodialysis at your dialysis center.