Our Vascular Access Services
Tri-County Vascular Care provides services for patients who need dialysis. Our staff is committed to providing the latest in imaging, diagnostic and interventional services, ongoing follow-up to these services, as well as patient education. Our goal is to maintain, preserve and/or restore dialysis access to patients experience a higher quality of life. Our highly skilled physicians and clinical staff know and understand your vascular access needs and how to best care for you. We provide the most common procedures required for dialysis. We have a convenient scheduling system and prompt response. We are ready to serve your vascular access needs.
Dr. Lindsay Pierce on PAD


Services We Provide
Vessel Mapping
AV Fistula Creation
Fistula Maturation Determination & Procedures
AV Graft Creation
Vascular Access Repair & Maintenance Procedures
Sometimes, additional procedures are needed to maintain or improve a patient’s vascular access after it has been created. These might include:
Angiogram
An angiogram provides a picture of the inside of the fistula or graft using x-rays. A local anesthetic is used and then a small needle is inserted, and dye is injected while x-ray pictures are observed to identify whether an additional procedure is needed.
Angioplasty
If the angiogram shows that the vascular access is narrowing, your doctor might perform angioplasty. A local anesthetic and possibly IV sedation are used for this procedure. 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
If a patient’s blood flow through the access area is blocked as the result of clotting, doctors might perform a procedure called a thrombectomy, to restore blood flow to the 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 Procedures
Catheter Placement
Inserting a tunneled cuffed hemodialysis catheter involves using a local anesthetic and possibly IV sedation. The catheter is placed in a vein in the patient’s neck (sometimes in the groin) to obtain access to the bloodstream. A tunnel is created under the skin, which leads up to the point where the catheter exits the body.
Catheter Exchange
Inserting a tunneled cuffed hemodialysis catheter involves using a local anesthetic and possibly IV sedation. The catheter is placed in a vein in the patient’s neck (sometimes in the groin) to obtain access to the bloodstream. A tunnel is created under the skin, which leads up to the point where the catheter exits the body.
Catheter Removal
When a patient’s catheter is no longer needed, it will be removed. 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 the removal is complete.
PD Catheter Procedures
Vascular Access Education for Patients & Caregivers
Provider Referral
To refer a patient for vascular access or PAD services, print and populate this referral form and send it to TCVC.
By fax: 408-225-2248
As a scanned attachment to an email: tuckerj@tricountyvascular.com