DIAGNOSTIC ANGIOGRAM

Diagnostic angiography is a procedure which physicians use to investigate abnormalities of the blood vessels. For the procedure a catheter is placed in the selected blood vessel and contrast is administered while a rapid set of x-rays is obtained analogous to time lapsed photography.

PAVF

A revolutionary new procedure, pAVF (percutaneous arteriovenous fistula) uses a tiny catheter device guided by ultrasound to establish vascular access in dialysis patients. Advanced Access Medical Care is not only certified to perform the pAVF procedure, but we’re also the very first practice in the tri-state area to offer this safe, effective, and minimally invasive treatment to our patients.

If you are just finding out about pAVF or if your specialist recommends the procedure, here’s why it’s becoming so popular:

• Avoid a Surgical Incision

• Eliminate a Hospital Stay

• Ready to Use in Less Time

• Immediate Access Maturation

• Reduces Risk for Ischemic Complications

If you have no prior access or are in Stage 4 or 5 renal failure and about to start dialysis, you are likely an ideal candidate for this convenient new procedure. Note that age is not in any way a factor when determining if you are an appropriate candidate for pAVF.

Contact Advanced Access Medical Care to schedule an evaluation to see if this innovative procedure is right for you.

ANGIOPLASTY AND STENT PLACEMENT

Angioplasty, with or without vascular stenting, is a minimally invasive procedure performed to improve blood flow in the body's arteries and veins.

In an angioplasty procedure, imaging techniques (typically fluoroscopy) are used to guide a balloon-tipped catheter, a long, thin plastic tube, into an artery or vein and advance it to where the vessel is narrow or blocked. The balloon is then inflated to open the vessel, deflated and removed.

During angioplasty, a small wire mesh tube called a stent may be permanently placed in the newly opened artery or vein to help it remain open. There are two types of stents: bare stents (wire mesh) and covered stents (also commonly called stent grafts).

DECLOTTING / THROMBECTOMY

The removal of a thrombus from a blood vessel, performed as emergency surgery to restore circulation to the affected part. Anticoagulant therapy may begin before surgery. An arteriogram is done to locate the thrombus. During surgery a longitudinal incision is made into the blood vessel, and the clot is removed. After surgery the blood pressure is maintained close to its preoperative level because a decrease would predispose to further clotting.

FISTULA MATURATION

Once a fistula is created, it must develop to the point that it is usable. The native vein has a thin wall and is relatively fragile. For maturation to occur, remodeling of the vessel must take place. This principally means that the AVF must be of adequate size to allow for successful repetitive cannulation and provide adequate blood flow to support the hemodialysis prescription. Prospective studies suggest that an AVF that will become adequate for dialysis is apparent relatively early in the postoperative period. Physical examination alone is a very good tool for assessing the development of a fistula.

CATHETER PLACEMENT, REMOVAL AND EXCHANGE

A vascular access procedure inserts a flexible, sterile plastic tube called a catheter into a blood vessel to allow blood to be drawn from or medication to be delivered to a patient’s bloodstream over an extended period. They may be used for intravenous (IV) antibiotic treatment, chemotherapy, long-term IV feeding and blood transfusions. Vascular access spares patients the stress of repeated needle sticks and provides a painless way to draw blood or deliver medication.

COMPREHENSIVE PERITONEAL CATHETER MAINTENANCE

Peritoneal dialysis (PD) has been a widely accepted method of treating end stage renal disease (ESRD) since the 1980s, and it is now the most common method of home dialysis. While many dialysis patients in the United States go to a dialysis center, PD offers more flexibility by allowing patients to dialyze at home, at work or on vacation.

To perform treatments, PD uses the thin membrane, called the peritoneum, which lines the abdomen. During treatments, a cleansing fluid called dialysate is put into the patient's abdomen through a small, flexible tube called a PD catheter.

The dialysate pulls the waste and extra fluid from the patient's blood into the peritoneal cavity and stays in the abdomen for a specified amount of time. Once the dialysate is drained, the wastes and fluids are also drained, and fresh dialysate is replaced to clean the blood. This filling and draining process is called an exchange because the dialysate that has been in the abdomen is being exchanged for new, fresh dialysate.

PRE-OP VASCULAR MAPPING FOR ACCESS PLACEMENT

Mapping of arm vessels before surgical creation of dialysis access has been shown to be useful in helping achieve a higher percentage of arteriovenous fistula (AVF) placements as well as an increased fistula success rate.

ULTRASOUND FLOW STUDIES

A Doppler ultrasound test uses reflected sound waves to see how blood flows through a blood vessel. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It can show blocked or reduced flow of blood through narrow areas in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism).

PAD ( PERIPHERAL ARTERIAL DISEASE )

Peripheral artery disease (P.A.D.) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood.

When plaque builds up in the body's arteries, the condition is called atherosclerosis. Over time, plaque can harden and narrow the arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body.

P.A.D. usually affects the arteries in the legs, but it also can affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach. This article focuses on P.A.D. that affects blood flow to the legs.