Fistulagrams are tests performed to evaluate the function of the fistula or graft. Several clinical indicators are used to determine how often these studies are performed. Indicators such as high venous pressures, low flow rates, prolonged bleeding, difficulty with cannulation, weak thrill
or bruie or pulsatile site are used to determine when a fistulagram is needed. Our plan is to be proactive in the care and maintenance of your dialysis access.
PERIPHERAL ARTERIAL ANGIOPLASTY
Often times a study will indicate a narrowing (stenosis) in the outflow vein or the inflow artery. When this occurs it is necessary to place a balloon catheter across the narrowed area and open that stenosis to prevent the graft from closing(clot).
PERIPHERAL ARTERIAL STENTING
Many times a balloon procedure alone will not fully treat a narrowing. When this happens and only if this happens, we can place a device called a ‘stent’ across the narrowed area and use the balloon to open the stent. This will keep the narrowing open.
FISTULA MATURATION PROCEDURES
During a Fistula Maturation Procedure, your surgeon will place a fistula, or surgically created pathway, in your arm. There is a waiting period until it is ready to use, where the fistula develops. This is often called the “fistula maturation.”
If a fistula doesn’t mature properly, we can use contrast and x-rays to find a reason why the maturation did not occur. After this process, we can then use angioplasty or coil embolization to assist in the fistula maturation process by re-routing or re-directing the blood flow into the fistula.
Even under the best of care, it is possible for your access to be blocked for various reasons. In order to provide the best care to you during your dialysis treatment, our center and vascular access experts are available to answer questions and provide care if you experience a blockage.
Once your center has determined that your access has clotted, we can set you up for your thrombolysis procedure. Through this procedure we will be able to get into your access site, find out why it not working, treat the problems and restore it to normal function.
We can also treat your catheter if it is blocked from a blood clot on the catheter. We can treat this using medication to dissolve the blood clot, mechanically removing the clot or by changing the catheter over a wire.
Gateway Vascular Center provides many services for patients needing dialysis. Our Center is committed to providing you with the most up to date state of the art imaging, diagnostic and interventions to meet your dialysis access needs. We will partner with you and your healthcare team to develop a plan of care that best suits your needs.
COMPLETE CATHETER SERVICES
(CENTRAL VENOUS ACCESS PLACEMENT FOR TEMPORARY USE)There are time when your need for dialysis is time sensitive and that working on your fistula will be too time consuming. That’s why Gateway Vascular offers complete catheter services.
When your need for dialysis is priority, we offer a central venous access for temporary use. During this procedure we will place a catheter in your neck or groin using an Ultrasound machine.
This Ultrasound machine will show us the best place to put a catheter without having to try multiple times, so that we can facilitate a quick and easy method of temporary central venous access for your dialysis.
Vessel mapping involves placing a small IV in your hand to inject an IV contrast (dye). This procedure will show us where your veins are. This helps your team of dialysis access experts, your Nephrologist and your surgeon develop a plan where best to place to your new fistula or graft.
TUNNELED CATHETER PLACEMENT FOR HEMODIALYSIS
When you are new to dialysis you may need to be dialyzed with a catheter until your fistula or graft is ready to use. At Gateway Vascular, we can place this type of catheter across your collarbone so that you have access to the dialysis you need until your fistula or graft is ready for use.