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

Vessel mapping is performed before your fistula or graft are placed. This procedure measures and evaluates arteries and veins to successfully create a vascular access. Testing may include using an ultrasound and a venogram, or an x-ray of the veins. A venogram involves inserting an IV and injecting 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 enables the vein to enlarge and the vein walls to strengthen so that needles can be used to access your bloodstream for dialysis.

Fistula Maturation Determination & Procedures

Once your 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 a patient’s fistula to be used for dialysis. The doctor will monitor the fistula’s maturation and perform additional procedures, if needed, 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 uses 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

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

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. When PD catheters are inserted, one end of the catheter is placed in the patient’s peritoneal cavity. The catheter will continue 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.

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

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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.