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Sensing Savvy

Getting a Permanent Vascular Access: A Lifeline for a Lifetime

Posted by Susan Eymann, MS on Aug 29, 2018 9:00:00 AM

Freedom from the use of a central venous catheter (CVC) is a goal for many end-stage-renal disease (ESRD) patients. They should work together with their Dialysis Care Team to develop a patient-focused vascular access plan to be followed at all sites of care whether it be at dialysis clinic; access center; hospital or outpatient facility. vascular-access

A Vascular Access Plan should include the following:

1. Generating an access plan and reviewing its steps;

2. Explaining how the surgeon will find the best site for the access;

3. Having a scheduled appointment with a vascular surgeon;

4. Undergoing surgery to create the vascular access;

5. Waiting for the access to mature or heal;

6. Using the access for hemodialysis;

7. Having the catheter removed once the vascular access is being used routinely;

8. Caring of the access for a lifetime with a daily one-minute check.

 

Vascular Access Options

vascular-access

Arteriovenous Fistulas (AVF): The Preferred Access

Surgical connection between an artery and vein

  • A continuous circuit;

  • Lowest complication rate;

  • 6-8 week maturation time;

  • Best long-term primary patency;

  • Requires the fewest interventions.

 

Arteriovenous Grafts (AVG)

  • AVG (synthetic or biologic materials)

  • Ready for use in 2-3 weeks;

  • Useful if veins prohibit AVF development;vascular-access

  • More infections than an AVF, but

    less than an catheter;

  • Tends to clot more often than AVFs.

Reference: www.esrdncc.org Lifeline for a Lifetime: Planning for Your Access developed by ESRD National Coordinating Center and Fistula First