For Physicians

Tri-County Vascular Care provides services for patients needing dialysis. Our staff is committed to providing the latest in imaging, diagnostic and interventional services, as well as patient education. We will coordinate with you to develop a plan of care surrounding your patients’ vascular access needs. Our goal as your endovascular center of choice is to maintain, preserve and/or restore dialysis access so patients enjoy a higher quality of life.

Services Provided

Vessel Mapping

Vessel mapping is performed prior to fistula or graft placement. This procedure measures and evaluates arteries and veins for successful vascular access creation. Testing may include an ultrasound and a venogram, or x-ray of the veins. A venogram requires insertion of an IV and injection of a small amount of dye.

AV Fistula Creation

An arteriovenous (AV) fistula is a natural type of vascular access where the patient’s vein is surgically connected to an artery. The increased blood flow that results from this connection causes the vein to enlarge and the vein walls to strengthen so that needles can be used to access the bloodstream for dialysis.

Fistula Maturation Determination & Procedures

Once the fistula is created, it will gradually increase in size over several weeks. Maturation is the term used to describe the changes in the vein that enable the patient’s fistula to be used for dialysis. The doctor will monitor the fistula maturation and perform additional procedures if necessary to determine when it is ready for dialysis.

AV Graft Creation

An arteriovenous (AV) graft is a type of access that is usually placed in the arm, but may be placed in the leg, if necessary. An AV graft is the connection of a vein and an artery that utilizes a hollow, synthetic tube. One end of the tube is connected to an artery and the other end of the tube is connected to a vein. As a result, the blood flow through the graft provides a flow rate that will deliver enough blood to provide an adequate hemodialysis treatment.

Vascular Access Repair & Maintenance Procedures

The following procedures are done in the vascular center to maintain optimal access function when an indication for evaluation is detected:

Angiogram – A picture of the inside of the fistula or graft using x-rays. A local anesthetic is used. A small needle is inserted and dye is injected while x-ray pictures are observed to identify whether an additional procedure is needed.

Angioplasty – Performed if a stenosis was observed on the angiogram. A local anesthetic and possibly IV sedation are used. A small catheter with a balloon at the tip is inserted and inflated to stretch the narrowed area. The balloon is removed at the end of the procedure. Sometimes a stent (a metal piece of mesh) is needed to support the vessel walls to keep the access open. The stent will remain inside the fistula or graft and does not move

Thrombectomy – A procedure performed to restore blood flow to a clotted access. A local anesthetic and IV sedation are usually used. The physician may use medications or devices to break up clots and to sweep and suction the clots away.

Catheter Placement

The insertion of a tunneled cuffed hemodialysis catheter. A local anesthetic and possibly IV sedation are used. The catheter is placed in a vein in the neck (sometimes in the groin) to obtain access to the bloodstream. A tunnel is created under the skin and leads up to the point where the catheter exits the body.

Catheter Exchange

Performed to improve blood flow or when there is an infection present. A local anesthetic and possibly IV sedation are used. The cuff is loosened and a wire is advanced through the catheter. The old catheter is removed and a new one is placed over the wire.

Catheter Removal

Will be performed when the catheter is no longer needed. The catheter exit site area is numbed using a local anesthetic. Once the cuff is freed from the tissue, the catheter slides out of the tunnel and removal is complete.

PD Catheter Procedures

If the patient chooses peritoneal dialysis, he/she will need a PD catheter, which is a soft, flexible plastic tube about the length of a ruler and the width of a pencil. During PD catheter insertion, one end of the catheter is put into their peritoneal cavity. The rest of the catheter will come through the patient’s lower abdomen, underneath and to the side of the belly button.

Vascular Access Education for Patients & Caregivers

We offer a series of educational programs for patients and dialysis caregivers to ensure that all patients get the best vascular access care possible.

Refer a Patient

Tri-County Vascular Care improves the patient experience and quality of life, by delivering superior clinical outcomes through comprehensive care coordination. We provide all-inclusive surgical and endovascular services designed to aid access maturation and ongoing maintenance and repair. Find out how Tri- County Vascular Care can meet your patients’ needs. Call to schedule a tour of our center to experience first-hand how we can work with you and your Nephrology care team.

What Our Patients Say

"Satellite Healthcare’s acquisition of Tri-County Vascular is beneficial to dialysis patients because it speeds up the process for patients in need of a fistula and helps to eliminate the use of catheters. I can honestly say it was a very quick turnaround from the time Dr. Kumar referred me to Tri-County Vascular Care to the time I actually had my procedure. I felt so relieved I was finally able to get rid of my catheter and get a fistula because they provide better access and are much safer and easier to clean."

"I had my fistula created at Tri-County Vascular Care in November 2018 and must say the doctors are excellent and really know what they are doing. And a key benefit to the partnership between Satellite Healthcare and Tri-County Vascular is that information can be shared quickly between the two organizations making follow-up appointments easier on dialysis patients."

Request an Appointment

Complete the form to request an appointment with Tri-County Vascular Care. A representative will contact you within 24 hours to review your medical information and schedule an appointment. If you are experiencing a medical emergency, please call 911.

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