Dialysis Access/ Fistulas

Patients diagnosed with advanced kidney failure or end-stage renal disease require renal replacement therapy, a treatment that replaces the function of the kidneys when they no longer work as well or as effectively as they should. One type of renal replacement therapy is hemodialysis, a process that uses a machine to remove blood from the body; extract waste, impurities, salt, and extra water from it; and return the clean blood back into the bloodstream. During hemodialysis, two needles are inserted into the body–one to remove the blood and send it to the filtering machine, and the second to allow blood to be safely returned to the body

Average or “normal” veins are not strong enough for hemodialysis. Not only are they unable to withstand the high speeds with which the blood is being pumped into the machine, but they would also collapse with the frequency and repetition of the dialysis procedure and regular needling.

Surgically created AV fistulas are essentially “super” blood vessels, stronger blood vessels that provide a more durable access point for dialysis treatment and enable dialysis patients to receive the life-saving therapy they need without compromising blood flow and function.

The creation of an AV fistula involves surgically connecting a vein to an artery via stitches. When the vein is connected to an artery, the connection allows for fast-moving blood to flow from the artery to the vein, bypassing the capillaries and increasing the blood flow through the vein. The vein gradually adapts, thickening and enlarging into a “super vein.” The enlarged vein is now strong enough to withstand the needling of regular dialysis and capable of delivering the amount of blood flow necessary to provide adequate and effective hemodialysis treatment.

With a fistula, your dialysis nurse can insert both needles directly into the AV fistula. This eliminates the need for plastic dialysis lines and provides ample enough blood flow that you may require shorter dialysis times.

At Colorado Vascular Associates, our comprehensive, whole-person approach to care means we do everything a little differently, from the procedure to our involvement with your dialysis treatment. Unlike other vascular surgeons who create a fistula but then do little to help maintain it afterward, the surgeons at Colorado Vascular Associates work closely with your nephrologist, providing routine maintenance and ultrasound surveillance to make sure your fistula is working properly and not compromising your health or your treatment.

Moreover, as a team of multidisciplinary specialists, we understand the symbiotic relationship between kidney function and other systems of the body; patients with kidney disease or failure also tend to have peripheral artery disease or coronary artery disease, and patients who are on dialysis are at a higher risk of limb loss. Not only do we have the diagnostic capabilities to closely monitor and screen for these increased cardiovascular risk factors, but we can also provide the additional interventions, procedures, and advanced treatments necessary to preserve your health.

At Colorado Vascular Associates, your fistula procedure can be performed as an outpatient surgery in our state-of-the-art facility. While the procedure takes a few hours and is conducted under local or general anesthesia, you will be able to recover on-site with one-on-one nursing care and go home the same day. And, because of our outpatient setting, the fistula procedure at Colorado Vascular Associates is less expensive than one performed in a hospital and carries a lower risk of complication or infection.

Here is what your fistula procedure will look like at Colorado Vascular Associates:

You will receive anesthesia in preparation for the fistula creation.

The vascular surgeon will make a small incision in your arm, providing access to the predetermined artery and vein, which will then be stitched together.

The incision will be closed with stitches, surgical glue or tape, or staples.

Your fistula will now need several weeks to heal and mature. During this time, the vein will undergo the process of arterialization (vascularization), in which the vein thickens and enlarges to become more like an artery and grows sturdy enough to withstand dialysis. It may take a month or longer for the fistula to mature enough to be used for your hemodialysis treatment.

Your health is determined by more than your dialysis, and at Colorado Vascular Associates, we take a whole-person approach to care that takes the entire patient into consideration. We work closely with other physicians and specialists within the community to create comprehensive care plans that are tailored to your unique needs and risk factors, and we develop long-term, long-lasting relationships with every patient to ensure they are experiencing the best health outcomes possible.

From advanced treatments and innovative techniques to a state-of-the-art outpatient facility featuring the latest technology, Colorado Vascular Associates continues to be at the forefront of complete vascular care, providing leading-edge solutions and much-needed hope to patients who have had heart or vascular conditions but no answers. Discover how AV fistulas and bypass grafts can make a difference in your dialysis treatment and schedule a consultation today.