Diagnostic Testing for Vascular Access: Ensuring Optimal Performance

Ensuring Optimal PerformanceIf problems arise with vascular access during dialysis, the patient will not receive the full benefit of treatment. It is important to feel confident in your ability to care for your access and have a care team that thoroughly checks your access at every visit. Premier Surgical Vascular Access & Imaging in Knoxville places high importance on educating patients about how to care for their access and play an active role in their treatment plan. Here are some tips from the National Kidney Foundation on how to keep a fistula or graft working properly for longer:

  • Check the blood flow several times each day by feeling for a vibration, also called a pulse or thrill. If you do not feel this, or if there is a change, call your doctor or your dialysis center.
  • Do not wear tight clothes or jewelry on your access arm.
  • Do not carry anything heavy or do anything that would put pressure on the access.
  • Do not sleep with your head on the arm that has your access.
  • Do not let anyone use a blood pressure cuff on your access arm.
  • Do not let anyone draw blood from your access arm.
  • Do not be afraid to ask your dialysis care team to rotate needle sites.
  • Apply only gentle pressure to the access site after the needle is removed. Too much pressure will stop the flow of blood through the access.
  • If you have breakthrough bleeding after you have dialysis, apply gentle pressure to the needle site with a clean towel or gauze pad. If the bleeding does not stop in 30 minutes, call your doctor or your dialysis center.

There are different types of testing used for the placement and preservation of your vascular access. At Premier Vascular Access & Imaging Center we use the following diagnostic testing:

Doppler: This exam is used to check the blood flow in the arteries of your arms and fingers.

Duplex/Ultrasound: Ultrasound examines a fistula or graft access to identify any potential problems.

Venogram/Fistulogram: This minimally invasive x-ray is performed to better visualize access flow and requires the injection of a dye to aid in imaging.

Should a problem develop with your access requiring help to return it to healthy function, there are a number of options depending on the specific problem:

Angioplasty/Ballooning: To repair and improve blood flow in a fistula or graft access, a physician may opt to thread a balloon-tipped catheter to the problem site and inflate the balloon to open up blocked or narrowed passage.

Declotting: If clotting is found to be the cause of an access blockage, your physician may opt to inject medication directly into the fistula or graft. Following injection, you will be monitored for several hours until declotting occurs to ensure no further steps are required.

Ligation of Branches: When a vein used to create access has too many branches of surrounding vessels, the vein may not have adequate blood flow to provide optimal dialysis. If this occurs, a minor surgery is performed to improve blood flow through the fistula by tying off the branches to strengthen blood flow through the access vein.

Premier Surgical Vascular Access & Imaging Center in Knoxville is designed to be as convenient as possible with patient care at the center of everything we do. Whether you are newly diagnosed or in need of treatment to enhance performance of your vascular access, we will work to get you in as quickly as possible. Our patients experience fewer infections, a more expedient treatment course and an increased comfort level. With same day referrals and convenient scheduling Premier Surgical Vascular Access & Imaging Center is your lifeline to healthy, ongoing care. Call (865) 588-8229 to schedule an appointment today.

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