A vascular access center or vascular center is an outpatient medical facility dedicated to providing critical care and maintenance for patients with dialysis access. A reliable and functional access point is essential for dialysis. If a problem or complication occurs with the dialysis access, a vascular specialist and clinical team perform outpatient procedures to improve access function as soon as possible. This enables the patient to return to their dialysis treatments in good time, avoiding inconveniences and complications of hospital admissions. 

Frequently Asked Questions (FAQs)

What is vascular access?

This is a direct, quick method to easily access a patient’s veins for their blood to be purified by a dialysis machine. The access is placed in the arm using different vascular methods.

What are the types of vascular access for hemodialysis?

There are three main types of access which include the arteriovenous graft (AV), the central venous catheter (CVC), and an arteriovenous graft (AV).

Which is the first choice for vascular access for dialysis?

An AV fistula is considered first because it lasts longer and has fewer complications like clotting or infections. A graft is the second option for access for patients who cannot receive an AV fistula because their blood vessels aren’t strong enough.

How long does it take for a fistula to fully mature so it can be used for dialysis?

Maturation takes 4 to 6 weeks after the initial surgery for arteriovenous fistulas, while it typically takes 2 to 3 weeks for arteriovenous grafts. The maturation process can be unpredictable and can vary from person to person.

Are there any risks of vascular access for patients undergoing hemodialysis?

Infection, blockages and thrombosis are common vascular access complications in hemodialysis patients. For fistula and grafts, narrowing (also called stenosis) of your blood vessels is the most common problem.

What is an angiogram?

This X-ray test utilizes a contrast agent (X-ray dye) and a camera (fluoroscopy) to capture images of blood flow through the access and adjacent blood vessels. This helps the vascular specialist see whether any blocked or narrowed vessels are causing a blood flow problem.

Will I be put to sleep during my test?

No. You will be consciously sedated (medication to help you relax) during the procedure or intervention to keep you comfortable.

Can I drive to the Carolina Vascular Care for my procedure?

You can drive to and from the Carolina Vascular Care center if your procedure involves local anesthesia. However, when you are scheduled to undergo a procedure using conscious sedation, you cannot drive after the procedure. Look for someone reliable to help and transport you to and from the center.

Can I eat before my procedure?

No. You need to be fasting i.e. do not eat or drink 8 hours before your procedure. 

How do I prepare for my procedure at the Carolina Vascular Care?

We will call you a day before your procedure to inform you what to do to prepare for your procedure. Take your morning medicines with a small sip of water unless you are told not to. You can call us a day before the procedure if you are not sure whether your procedure is being performed under local anesthesia or conscious sedation. 

Why should I come an hour before my procedure?

Coming early enables our nurses to prepare and complete your paperwork before your procedure. You will also require an assessment from the doctor before the procedure.

What happens when I go for my procedure at Carolina Vascular Care?

When you arrive, you will be asked to fill out a questionnaire, then taken to the pre-procedure area to change into a hospital gown. A nurse will prepare you for the procedure, and our vascular physician will answer any questions you have. The physician will also inform you about the procedure and any potential risks. After obtaining your consent, you will be transferred to the procedure room.

 What happens during the procedure?

Your heart rate, oxygenation and blood pressure will be carefully monitored. Before carrying out the procedure, we will sedate you or administer local anesthesia. An X-ray machine and if needed an X-ray dye would then be used to diagnose any issues. A physician would then perform necessary interventions to address the issues.

What happens after the procedure? 

If you received local anesthesia, you could leave after the procedure, while if you received conscious sedation, you would be monitored in the recovery area for about half an hour. You should not drive, take alcohol, sign any legal or important documents, or operate machinery for 24 hours if have been under conscious sedation. Follow your doctor’s instructions after you get home.

What can I do to keep my dialysis access in good condition?

  • Keep the site clean by washing your skin with soap and water daily and keeping it dry, especially the day before your dialysis.
  • Examine your access daily and check out for any redness, pain, bleeding, oozing, swelling, or change in thrill (vibration). If you suspect a problem, inform your dialysis provider immediately. 
  • Avoid sleeping on your access arm and avoid carrying or lifting heavy objects with it.
  • Do not let anyone check blood pressure, draw blood, or place an IV line on your access arm.
  • To minimize the risk of infection, avoid scratching, coughing or sneezing on your access.
  • No one should touch your access except your dialysis care providers.
  • Avoid constructive jewelry or clothing with tight armbands on your access arm.

What happens if my access is no longer functioning properly?

To correct the problem, you will require an interventional procedure to fix your access. Depending on the cause of your access malfunction, a minimally invasive, image-guided procedure might be performed.

Why should I come to Carolina Vascular Care Center?

We are committed to putting the needs of every patient at the forefront by providing quality and comprehensive vascular access  services. Our highly trained and experienced staff serve our patients using state-of-the-art vascular access care customized to meet every person’s unique needs.

For more information or questions about vascular access, don’t hesitate to contact us today to request an appointment.