At Atlanta Access Care, we offer the full scope of care for patients with ESRD. To create optimal care for these patients, they need procedures performed on their veins, arteries, and accesses.

Dialysis Access Procedures

Our physician specializes in the following procedures:

  • Dialysis Access Procedures – thrombectomy, fistulagrams, fistula maturation and the Miller Procedure
  • Central line placements (powerports, PICCS, groshongs, dialysis/pheresis catheters)
  • Venograms, Venous angioplasty/stents

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Dialysis Access Procedures

Our physician specializes in the following procedures:

  • Dialysis Access Procedures – thrombectomy, fistulagrams, fistula maturation and the Miller Procedure
  • Central line placements (powerports, PICCS, groshongs, dialysis/pheresis catheters)
  • Venograms, Venous angioplasty/stents

Dialysis Access Management for the Atlanta Community

dialysis access stenting

Angioplasty, Stenting, and Fistula Salvage

Many poorly functioning accesses suffer from stenosis, which is a blockage or narrowing in the access. To open a stenosis, we may intervene with angioplasty and/or stent placement to improve blood flow. In angioplasty, a small balloon, mounted on a catheter, is inflated within the blood vessel, expanding the narrowed access. If necessary, we may also insert a metal stent to maintain even blood flow throughout the access. For arteriovenous (AV) fistulas that have not “matured” for optimal dialysis treatment, we can provide a series of angioplasty and/or stenting treatments to expand the access. This series of access interventions, performed over the course of a few weeks, is known as fistula salvage.

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thrombectomy graphic

Thrombectomy and Thrombolysis

For clotted accesses, we offer thrombectomy (or embolectomy), to remove thrombi (blood clots) from the access. Mechanical thrombectomy devices can remove clots from both AV fistulas and grafts, creating a vacuum effect to pull out the clots. Another alternative to remove clots is thrombolysis, which utilizes pharmacological methods to break down or break up these blood clots.

dialysis-access-management-the-miller-procedure-for-steal-syndrome

The MILLER Procedure for Steal Syndrome

Steal syndrome is a clinical condition caused by arterial insufficiency distal to the dialysis access (area furthest away from the access). Blood is diverted into the fistula or graft and away from the hand. To correct the balance of blood flow, we offer a banding technique, the Minimally Invasive Limited Ligation Endoluminal-assisted Revision (MILLER) procedure to accurately manipulate the access to the proper size and allow for even blood flow. This procedure uses an angioplasty balloon as a sizing dowel, allowing our physicians to band accesses to their desired diameter to treat steal syndrome and high-flow accesses.
central venous catheter

Central Venous Catheter Placement

We offer dialysis catheter placement. The catheter is a flexible hollow tube which is tunneled under the skin from the point of insertion in the vein to an exit site on the chest wall. However, catheters are typically only used up to three weeks because they are prone to clotting, infection, and kinking. A catheter may be placed while a fistula or graft is waiting to mature. Once your AV fistula or graft is functioning properly, we will safely remove your dialysis catheter.

Want to meet with a Dialysis Access Physician in Atlanta, GA?

Request an appointment today and meet with one of our board certified physicians in our convenient Decatur location.

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