Clinical Procedures
DIAGNOSTIC ANGIOGRAM
Diagnostic angiography is a procedure which physicians use to investigate abnormalities of the blood vessels. For the procedure a catheter is placed in the selected blood vessel and contrast is administered while a rapid set of x-rays is obtained analogous to time lapsed photography.
ANGIOPLASTY AND STENT PLACEMENT
Angioplasty, with or without vascular stenting, is a minimally invasive procedure performed to improve blood flow in the body's arteries and veins.
In an angioplasty procedure, fluoroscopy is used to guide a balloon-tipped catheter, a long, thin plastic tube, into an artery or vein and advance it to where the vessel is narrow or blocked. The balloon is then inflated to open the vessel, deflated and removed.
During angioplasty, a small wire mesh tube called a stent may be permanently placed in the newly opened artery or vein to help it remain open.
DECLOTTING / THROMBECTOMY
The removal of a thrombus from a blood vessel, performed as emergency surgery to restore circulation to the dialysis access. During your procedure an arteriogram is done to locate the thrombus, while medications, angioplasty and mechanical devices may be used to remove the thrombus and restore blood flow.
FISTULA MATURATION
Once a fistula is created, it must develop to the point that it is usable. The native vein has a thin wall and is relatively fragile. For maturation to occur, remodeling of the vessel must take place. This principally means that the AVF must be of adequate size to allow for successful repetitive cannulation and provide adequate blood flow to support the hemodialysis prescription. Prospective studies suggest that an AVF that will become adequate for dialysis is apparent relatively early in the postoperative period. Physical examination alone is a very good tool for assessing the development of a fistula.
CATHETER PLACEMENT, REMOVAL AND EXCHANGE
A vascular access procedure inserts a flexible, sterile plastic tube called a catheter into a blood vessel to allow for dialysis. Catheters are placed when an AV Fistula or graft has been placed and is not ready for use or there are no other options for a permanent access.
PRE-OP VASCULAR MAPPING FOR ACCESS PLACEMENT
Mapping of arm vessels before surgical creation of dialysis access has been shown to be useful in helping achieve a higher percentage of arteriovenous fistula (AVF) placements as well as an increased fistula success rate.
ULTRASOUND FLOW STUDIES
A Doppler ultrasound test uses reflected sound waves to see how blood flows through a blood vessel. It helps doctors evaluate blood flow through your access.