Vascular Access

Vascular access for dialysis

Dialysis is a medical treatment that involves passing the blood through a specially designed filtering system that removes toxins. This function is normally performed by the kidneys, so it is a life-saving treatment in the event of kidney failure.

Haemodialysis, the most common type of dialysis, is usually done through a blood vessel in the arm called fistula, or a line embedded onto your chest and most often an in-centre treatment. To make this treatment possible small operations are needed to put special access points in place within the body for the dialysis; this is called dialysis access or vascular access. These procedures can be performed using minimally-invasive techniques and include:

• Arteriovenous fistula – this is an operation that connects an artery and a vein, usually in the arm, which can be used to as an access point for connecting the individual to dialysis
• Central venous catheter – a soft tube that is placed in a large vein, usually in the neck.
• Arteriovenous (AV) graft – a connection between an artery and vein.
• Fistuloplasty – sometimes the arteriovenous fistula can become narrowed or blocked. Fistuloplasty aims to open up the fistula from inside the blood vessel. This is done using a small balloon, which is passed into the fistula via another blood vessel using a long, thin wire. The balloon is then inflated inside the vessel to widen it. This can also be done surgically.

Other minimally-invasive renal surgery

Renal surgery can extend to operations that are performed on organs and structures related to the kidneys, such as surrounding blood vessels. An example include:

• Surgery for aneurysms of the renal artery – swellings in the blood vessels that supply your kidneys (the renal arteries) can stop the kidneys working well. These swellings are known as ‘aneurysms’ and can be fixed surgically.