When patients reach end-stage renal disease (ESRD) and their kidneys can no longer filter waste and fluid effectively, one of the first and most urgent medical needs becomes establishing safe and reliable vascular access for dialysis.
While nephrologists manage kidney disease and dialysis plans, vascular surgeons play a critical and ongoing role in creating, maintaining, and preserving the lifelines that make dialysis possible.
At The Cardiovascular Care Group, our multidisciplinary collaboration with nephrologists, dialysis centers, and hospital teams ensures that patients receive the right access at the right time—with long-term planning in mind.
As kidney function declines to its final stages, patients may experience:
Often, patients with ESRD require urgent hospitalization. In many cases, there is not yet a mature long-term dialysis access in place, so the medical team must act quickly to begin life-sustaining dialysis.
This is where vascular specialists step in.
A tunneled hemodialysis catheter, often called a Permacath, is placed into a major central vein (usually the internal jugular). It allows dialysis to begin immediately.
However, Permacaths are not a long-term solution. They carry higher risks of:
Due to these risks, the goal is always to transition patients to the safest long-term option as soon as possible.
Once the patient is stabilized, the next step is vein mapping, performed in our in-office Noninvasive Vascular Laboratory, accredited and staffed by experienced vascular technologists.
This diagnostic step ensures the patient receives the most suitable form of long-term access.
An arteriovenous fistula is created when a vascular surgeon connects an artery to a vein, usually in the arm. Over time, the vein becomes larger and stronger, making it ideal for repeated dialysis needle placement.
However, an AVF requires weeks to months to fully mature. During this time, the Permacath remains in place until the fistula is ready.
If a patient’s veins are too small or unsuitable for an AVF, an arteriovenous graft may be recommended. This involves using a synthetic tube to connect the artery and vein.
While AVGs have a slightly higher risk of complications compared to fistulas, they remain an excellent long-term option.
The work of the vascular surgeon doesn’t end once access is created. Dialysis access requires continuous monitoring to prevent complications and ensure optimal performance.
At The Cardiovascular Care Group, we provide:
Working hand-in-hand with dialysis nurses and nephrologists, our goal is always the same: keep the access working and keep the patient safely dialyzing.
Dialysis patients rely on a strong support network. At every stage from emergency catheter placement to long-term access management, vascular surgeons are essential members of the care team.
Our collaboration with:
ensures that patients receive seamless care and timely intervention.
Since 1963, The Cardiovascular Care Group has been committed to excellence in vascular and endovascular care. As one of New Jersey’s most experienced vascular practices, we are proud to help guide patients through every phase of dialysis access from initial diagnosis through long-term management.
If you or a loved one needs dialysis access evaluation, fistula creation, or ongoing access care, our specialists are here to help.