Dialysis Access

When an individual’s kidney function fails due to conditions such as hypertension, diabetes, or other illnesses, dialysis treatments or a kidney transplant may be necessary to sustain life. Similar to the function of kidneys, hemodialysis is a procedure that cleans the blood of toxins and removes excess fluid from patients with kidney failure. Our vascular surgeons have extensive experience providing access for patients who need dialysis treatment.

The three points of access for dialysis are through a catheter, through an arteriovenous (AV) graft, or an arteriovenous (AV) fistula. A catheter is inserted into a large vein in either the neck or under the collar bone. It is usually a short term option because it can easily get infected.

Arteriovenous (AV) Graft

An arteriovenous (AV) graft is created by connecting a vein to an artery using a soft plastic tube. After the graft has healed, hemodialysis is performed by placing two needles in the graft. Grafts tend to need attention and upkeep. Taking good care of your access may limit problems.

Arteriovenous (AV) Fistula for Hemodialysis

A fistula used for hemodialysis is a direct connection of an artery to a vein. This is the preferred type of access (known as the gold standard) because once the fistula matures and gets bigger and stronger it can be used for dialysis for years with minimal risk of infection. However, not all patients are good candidates for this type of access. After the fistula is created by your surgeon, it can take weeks to months before the fistula matures and is ready to be used for hemodialysis. People with kidney disease can do exercise, including squeezing a rubber ball, to strengthen the fistula before use.

The surgeons in our vascular surgery division are experts in dialysis access – tailoring the type of access to each patient’s physical condition, anatomy, and lifestyle. Once the appropriate access for dialysis is established, our vascular surgeons closely monitor and maintain these grafts and fistulae to insure that they are functioning properly. In some cases, maintaining the access requires the use of clot-dissolving medication, stenting, or ballooning of the arteries or veins.


Contact Us

Tel: 212-241-5315

Division of Vascular Surgery
5 East 98th Street, 3rd Floor
New York, NY 10029