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Procedures Performed

  • 1.) Declot or Thrombectomy – This procedure removes the clot and re-establishes blood flow in the dialysis access. A clotted dialysis access cannot be used so we aim to perform this procedure as soon as the clot is discovered.
  • 2.) Angiogram/Fistulogram – A contrast agent is injected through the graft or fistula to determine the cause of the blood flow problem. When a stenosis or narrowing is found, this procedure may also require an angioplasty (dilatation of the blood vessels) and/or a stent.
  • 3.) Angioplasty – A balloon catheter is inserted into the graft or fistula and inflated to make it wider.
  • 4.) Stent Placement – This metallic device holds open a blood vessel that has continued to narrow after an angioplasty.
  • 5.) Tunneled Dialysis Catheter Insertion – A dialysis catheter is placed in one of the central veins in the neck or leg.
  • 6.) Tunneled Dialysis Catheter Exchange – The catheter is replaced by a new or different type of catheter.
  • 7.) Tunneled Dialysis Catheter Removal – Removal of catheter when no longer needed.
  • 8.) Temporary Catheter Insertion – This dialysis catheter is usually placed in a central vein and is intended for less than one week of usage.
  • 9.) Vessel Mapping – Before surgery to create an arteriovenous access, vessel mapping uses ultrasound and venography to determine the artery and vein anatomy to best see what type of access surgery should be done and where that access should be created.
  • 10.) Ligation/Coiling of the accessory/ Unnecessary vein and fistula. Reducing or restricting flow in access that is no longer needed.
  • 11.) Banding of high flow Arterio-venous Fistula (AVF).
  • 12.) Aneurysm or pseudoaneurysm repair/ revision of fistula.
  • 13.) Peritoneal dialysis catheter placement, removal, and repositioning.
  • 14.) Port Placement- Tunneled central line placement for IV use.
  • 15.) Coil Placement. Coil/s placed in accessory veins to prevent the diversion of blood from the main channel of the access.
  • 16.) Endo AFV creation- A minimal invasive fistula creation.
  • 17.) Maturation of Acess- Maturation of poorly developing fistula to help with successful cannulation.
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Reasons for Referral

  • 1.) Currently have a dialysis catheter and need to have vessel mapping prior to surgery to place an arteriovenous access in the arm.
  • 2.) Difficulty cannulation the access on dialysis.
  • 3.) Maturation of a fistula should happen by 4-5 weeks after its creation. Lack of development of the proper size fistula might should prompt early intervention.
  • 4.) Arm swelling/edema with or without bruising could be due to infiltration from cannulation on dialysis. Development of large aneurysms on the fistula or pseudoaneurysms on graft.
  • 5.) Increased venous pressures on the dialysis machine.
  • 6.) Increased negative arterial pressure on the dialysis machine.
  • 7.) Yellow/Red light on the stop light (not green) during dialysis.
  • 8.) Low Kt/v or URR, which means poor clearances on dialysis.
  • 9.) Pain in the access arm or hand.
  • 10.) Prolonged bleeding at the needle cannulation sites.
  • 11.) Dialysis catheter not achieving blood flow of at least 300 ml/min.
  • 12.) Dialysis catheter infection.
  • 13.) Low access flow measurement (on the dialysis machine or transonic device) indicating an arteriovenous graft with access flow less than 600 ml/min.
  • 14.) Accessory flow of the fistula into side branches instead of the main fistula channel.
  • 15.) Pulling clots on dialysis tubing through needle.
  • 16.) Clotted access without anyflow through the access.
  • 17.) Abdominal pain and infection in abdomen requiring PD catheter reposition or removal, respectively.
  • 18.) Need for initiating dialysis either with a PD or tunneled dialysis catheter. Due to lack of timely placement or development of AVF/G, some patients have to start dialysis on a dialysis catheter.
  • 19.) Infection at the catheter insertion site also known as exit site, or in the track of the catheter, with or without positive blood cultures (bloodstream infection), needs catheter exchange or removal depending on severity of infection. Similarly, PD catheter related peritonitis (infection of the abdominal lining) may require catheter removal.

How to refer to an RMA Access Center

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  • 505 998 7461
  • 505 314 0795
  • 505 998 7466