Dialysis Access Management

SMVI provides various procedures for patients undergoing dialysis.

What is dialysis?
Dialysis is a process by which blood is cleaned of impurities. You may undergo dialysis if your health care provider diagnoses you with end stage renal disease (ESRD), also known as kidney failure.

Procedures offered at SMVI

1) Angiopasty, stent placement, and declotting of dialysis grafts and fistulae. One or more of these procedures may be performed for a graft or a fistula that is not functioning optimally, or has become clotted.

Angioplasty is performed with a catheter with a small balloon at its tip. The balloon is placed at an area of narrowing in the graft, and is expanded gently to open the narrowing.

A stent is a very small metal tube that is placed in an area of narrowing to hold it open. A stent may be placed if a narrowing does not improve with angioplasty.

Declotting is performed with a medication that is injected into the graft or fistula to dissolve blood clot. This is also known as thrombolysis. The medication is usually first placed into the graft or fistulae, and then angioplasty is usually also done.

2) Placement of dialysis catheters. Your health care provider may want you to have a dialysis catheter placed, if you require dialysis and do not have a functioning dialysis graft or fistula. Catheters are usually placed into a vein in the upper chest area under ultrasound and xray guidance. A catheter may be tunneled (passes under the skin for 2-3 inches before coming out), which can be left in place for a long time, or may be nontunneled (does not pass under the skin), which are usually used for a shorter length of time.

How are the procedures performed?
All procedures are performed under carefully monitored sterile conditions. The skin over the area to be treated will be cleaned. A nurse will attach monitoring leads to you, to monitor your heart rhythm and your breathing. Medication may be provided through an IV (IV sedation) to make you comfortable. Local anesthetic is also used to numb the area.

After the procedure, you will be observed in the office for up to 2 hours. If you received IV sedation, you will need someone to drive you home.

It is the mission of SMVI to provide comfortable care in a safe and pleasant environment.

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