Dialysis Access Procedures

Dialysis Access Procedures

Vascular Institute of Chattanooga performs a range of dialysis access procedures tailored to treat patients’ medical needs. To learn about these procedures and what they entail, click each one below.

A fistula is a connection between two body parts, such as an organ and a blood vessel, or another structure that normally do not connect. When a fistula is created for dialysis, an artery and a vein are connected. The vein enlarges and thickens over time, allowing two needles to be placed and the dialysis process to occur.

AV fistulas (AVF) can be created in your wrist, forearm, inner elbow, or upper arm. Your AVF can be created either with open surgery (surgical AVF) or with a minimally invasive procedure (EndoAVF). WavelinQ™ EndoAVFs are created in the upper forearm. While maturation varies, some AV fistulas are able to function for many years. Two thin devices create a connection between your vein and artery without the need for open surgery. The devices are removed from the body once the connection is created. Magnets align the devices. and a connection is made between the vein and artery in the forearm. The doctor then removes the devices. The arm heals without stitches with little to no scarring.

Patients undergoing dialysis treatment must have vascular access that is working properly to maintain the blood flow to and from the hemodialysis machine. A fistulagram is an endovascular procedure where contrast dye can be inserted into the fistula to determine the problem of the malfunctioning fistula. An angioplasty can be performed with a balloon catheter being placed into the fistula to expand a blocked area, restoring the flow. If the vessel walls are too weak, a stent – or a mesh wire tube – is inserted to support the vessel walls and maintain blood flow. When the blood flow becomes inadequate due to the narrowing of the blood vessels, a surgical graft may be needed to restore flow.


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