Surgical Dialysis Access

Surgical Access Procedures

For patients who require dialysis, having reliable access to the bloodstream is essential for effective treatment. Surgical dialysis access provides established, long-term options for hemodialysis and peritoneal dialysis, depending on each patient’s needs.

At Pedes Venous Institute, we help guide patients through the process of selecting and maintaining the most appropriate access type, working closely with specialists and care teams to support safe and effective treatment.

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Temporary Access for Hemodialysis

Hemodialysis (HD) catheters are typically used as a temporary access option when long-term access is not yet available or needs maintenance.
These catheters provide direct access to the bloodstream and are often placed while a more permanent solution, such as a fistula or graft, is being prepared or restored.
During the procedure:

A local anesthetic is used to numb the area

A small access point is created in the skin

The catheter is guided into a large vein using imaging

HD catheters are effective for short-term use but are associated with a higher risk of infection over time. As such, they are generally not intended as a long-term solution.

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PD Catheter Placement/Removal

Surgical PD Catheter Placement

A peritoneal dialysis (PD) catheter allows for dialysis to be performed through the abdominal lining rather than the bloodstream.

Surgical placement is typically a minor procedure and may involve:

General anesthesia

A short procedure time (often under one hour)

Same-day discharge for many patients

This approach is commonly performed in a hospital setting ad provide reliable acces for peritonial dialysis

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Percutaneous PD Catheter Placement

A percutaneous PD catheter placement is a less invasive alternative that uses imaging guidance instead of open surgery.

This technique typically involves:

Local anesthesia with light sedation

Small access points rather than large incisions

Same-day discharge

Using fluoroscopy (real-time X-ray imaging), the catheter is carefully guided into position within the abdomen and secured for use.

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Surgical Fistula & Graft Creation (AVF/AVG)

Long-Term Dialysis Access Options

Arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) are commonly used for long-term hemodialysis access.

Before the procedure, patients undergo evaluation, which may include:

Physical examination

Vein mapping ultrasound

Imaging to assess artery and vein health

If a patient is a suitable candidate, the procedure is scheduled and performed by a vascular specialist.

During the procedure, local anesthesia is administered, and a small incision is made to access the blood vessels. A connection between an artery and a vein (AVF) is then created, or a synthetic graft is used (AVG). This connection increases blood flow, allowing the vein to strengthen and expand over time so it can support dialysis treatments.

After placement, the access site typically requires time to mature before it can be used, which may take several weeks depending on the individual.

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Choosing the Right Dialysis Access

Each type of dialysis access offers different benefits depending on your health, lifestyle, and treatment needs. At Pedes Venous Institute, we work closely with you and your care team to determine the most appropriate option.

Our goal is to ensure you have reliable, long-term access while supporting your comfort and overall well-being throughout treatment.

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