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Dialysis Access

Fistulas/Dialysis Access

A fistula is a surgical connection that is made by joining a vein onto an artery, usually in your arm. This creates a large blood vessel that can be accessed regularly for hemodialysis.  This allows a dialysis machine to take blood from your body and filter it through a machine to remove toxins and then returned to you. Dr. Senkowsky and our team works closely with your nephrologist to help provide the right access that will work best for you.

Fistula Formation

Fistula is created by a Vascular Surgeon, Dr. Senkowsky, under general anesthesia. The surgeon will take the artery, that carries blood from the heart, and the vein, which carries blood back to the heart, and joins them together by making a small opening between them. This will allow some of the blood to be redirected to the vein. This enlarges the fistula to allow higher blood flow that is needed for dialysis. Following the surgery the team will be teaching you to feel and check your fistula daily.  A fistula does take about 3 months to mature following surgery. You will have a 3 month follow up ultrasound to check the fistula and make sure it has matured and ready for hemodialysis.

At Complex Health Solutions, we specialize in the creation, maintenance, and management of dialysis access/fistulas, ensuring optimal care for our patients undergoing hemodialysis. We are proud to offer a comprehensive range of services for dialysis access care, including the ability to perform fistulograms and select interventions in our on-site Outpatient-Based Lab (OBL). Our state-of-the-art facility is equipped with the latest technology and staffed by experienced vascular specialists, allowing us to provide efficient and effective diagnostic and treatment options for patients with dialysis access/fistulas. Whether it’s evaluating the function of your fistula or performing necessary interventions, you can trust our team to deliver exceptional care in a comfortable and convenient setting.

Treatment options for dialysis access complications may include:

  • Antibiotics: In the case of infection, antibiotics may be prescribed to control the infection and prevent its spread. It is crucial to address infections promptly to minimize the risk of further complications.
  • Thrombectomy or Thrombolysis: In the presence of a blood clot within the AV fistula or the surrounding vessels, procedures such as thrombectomy (surgical removal of the clot) or thrombolysis (use of medications to dissolve the clot) may be performed to restore blood flow.
  • Angioplasty and Stenting: For cases of stenosis or narrowing within the AV fistula or the connecting blood vessels, angioplasty may be recommended. This procedure involves using a balloon catheter to widen the narrowed area, and a stent may be placed to keep the blood vessel open.
  • Fistula Revision or Surgical Repair: In some instances, surgical intervention may be necessary to address complications that cannot be resolved through less invasive methods. Fistula revision or surgical repair may be performed to restore or improve the function of the AV fistula.

Our experienced vascular specialists will assess each patient’s specific needs and develop a tailored treatment plan to address any complications related to dialysis access/fistulas, ensuring optimal function and safety during hemodialysis sessions.



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