Vascular access refers to the method in which kidney failure patients can undergo haemodialysis. The vascular access is used to remove the patient’s blood so that it can be filtered through a dialyzer machine to cleanse the blood and remove excessive fluid. There are 3 types of vascular access: an implanted Central Venous Catheter, an ArterioVenous Fistula (AV) or an ArterioVenous Graft (AVG).
Catheter access, sometimes called a Permanent Catheter or CVC (central venous catheter), consists of a plastic catheter with two lumens which is inserted into a large vein (usually the internal jugular vein or the femoral vein) to allow large flows of blood to be withdrawn from one lumen, to enter the dialysis circuit, and to be returned via the other lumen.
There are 2 types of CVCs, tunnelled and non-tunnelled:
Treatment of CVS requires a procedure known as a Venoplasty. In this procedure, a vein in the arm or in the leg is accessed and a sheath (tube) placed. Through the sheath, a wire is passed across the CVS and a balloon used to dilate the narrowing thus improving the vein drainage. Sometimes if the narrowing is very resistant to simple balloon dilatation, then a stent (metal supporting strut) may be placed across it to keep the vein open. The Venoplasty and Stenting can be done under local anaesthesia or mild sedation and as a day surgery procedure.