At Vascular Access Center of Illinois – Morgan Park, we offer several types of vascular access:

• Arteriovenous (AV) Fistulas: A surgical connection between an artery and a vein, typically in the arm. AV fistulas are considered the gold standard due to their durability and low complication rates.
• AV Grafts: Synthetic tubes that connect an artery to a vein. AV grafts are suitable for patients who cannot receive AV fistulas.
• Central Venous Catheters: Temporary access points inserted into large veins, usually in the neck or chest. These are used for immediate access but carry a higher risk of infection and complications.
• Peritoneal Dialysis Catheters: Used in peritoneal dialysis, these catheters are placed in the abdominal cavity, allowing for home-based dialysis treatments using the peritoneal membrane as a natural filter.

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Your healthcare provider will evaluate your medical history, vascular health, and individual needs to determine the most suitable type of vascular access. They will discuss the options with you and recommend the best choice based on your specific circumstances.

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Vascular access mapping is a diagnostic procedure used to assess the veins and arteries in preparation for creating a vascular access site for dialysis. This helps determine the best location and type of access (e.g., AV fistula, AV graft). Here is what you can expect during the procedure.

• Ultrasound imaging: The most common method for vascular access mapping is Doppler ultrasound. A gel will be applied to your skin, and a handheld device (transducer) will be moved over the area to visualize the veins and arteries.
• Other Imaging Techniques: In some cases, additional imaging techniques such as venography (using X-ray and contrast dye) may be used to obtain detailed images.
• Reviewing Results: The results of the mapping will be reviewed by your healthcare provider and your designated dialysis clinic to plan the optimal site and type of vascular access. In some cases, Dr Nazeer will perform Percutaneous AV fitsula creations for patients following mapping procedures himself. Following the access placement, you are now able to proceed with dialysis care.

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Proper care of your vascular access site is essential to prevent infections and ensure its longevity. Our team will provide you with specific care instructions, including how to clean the site, monitor for signs of infection, and activities to avoid to protect your access.

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If you notice any signs of infection (redness, swelling, pain), experience difficulty with your dialysis treatments, or have any concerns about your vascular access, contact our office immediately. Prompt attention can prevent complications and ensure your access remains functional.

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Regular monitoring is essential to detect and address issues early. Your healthcare provider will recommend a schedule for routine check-ups based on your individual needs and treatment plan, typically including physical exams and imaging studies.

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Maintaining a healthy lifestyle is critical to supporting your vascular access and overall health. This includes eating a balanced diet, staying active, managing stress, avoiding smoking, and following your healthcare provider’s advice regarding medications and treatments.

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For dialysis patients, maintaining clear and functional vascular access is crucial for effective treatment. Angioplasty can help:

• Prevent Access Failure: By clearing blockages and widening vessels, angioplasty can prevent the failure of arteriovenous (AV) fistulas or grafts used for dialysis.
• Improve Dialysis Efficiency: Ensuring good blood flow through the access site allows for more efficient dialysis sessions.
• Reduce Complications: Timely angioplasty can reduce the risk of complications associated with poor blood flow, such as clotting or infection.

Recovery and Aftercare:

• Minimal Downtime: Angioplasty is typically an outpatient procedure with a relatively quick recovery time.
• Post-Procedure Monitoring: Patients will be monitored for a short period after the procedure to ensure there are no immediate complications.
• Care Instructions: Patients will receive specific instructions on how to care for the access site and what symptoms to watch for that might indicate a problem.

Check-ups matter:

Angioplasty is a vital procedure that helps maintain the health and functionality of vascular access for dialysis patients. At Vascular Access Center of Illinois – Morgan Park, our experienced team is dedicated to providing expert care and ensuring that your vascular access remains in optimal condition.

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Our team at Vascular Access Center of Illinois – Morgan Park is always here to help. Whether you have questions, need additional information, or require support, please don’t hesitate to reach out to us. We’re dedicated to providing personalized care and empowering you to manage your health effectively.

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Recognizing the signs that your vascular access may need attention is crucial for maintaining its functionality and preventing complications. Here are some key indicators that you should be aware of:

Signs That Your Vascular Access May Need Attention:

1. Swelling: Unusual swelling around the access site or in the arm or hand can indicate a problem. It might suggest a blockage or other issue with the access.
2. Redness or Warmth: If the skin around your access site becomes red, warm, or tender to the touch, it could be a sign of infection or inflammation.
3. Pain: Persistent pain at the access site, especially if it’s new or worsening, should be evaluated by your healthcare provider.
4. Changes in Bruit or Thrill:
   • Bruit: The whooshing sound you can hear with a stethoscope over your access.
   • Thrill: The vibration you can feel when you place your fingers over the access.
   • Any changes in the intensity or absence of the bruit or thrill can indicate a problem with blood flow through the access.
5. Bleeding: Unexpected or prolonged bleeding from the access site after dialysis or spontaneously can be a sign of a complication.
6. Decreased Flow Rate: If you notice a reduction in the flow rate during dialysis sessions, it might indicate a narrowing or blockage in the access.
7. Increased Venous Pressure: Higher than normal venous pressure readings during dialysis can signal a potential issue with the access.
8. Fluid Accumulation: Swelling or fluid buildup around the catheter exit site (for peritoneal dialysis patients) or in the surrounding areas can indicate a problem.
9. Fever or Chills: Experiencing fever or chills without an obvious cause may indicate an infection in the access site.
10. Difficulty Cannulating: Difficulty inserting the needle into the access site or accessing it for dialysis can suggest issues such as stenosis or clotting.

What to Do If You Notice These Signs:

• Contact Your Healthcare Provider: If you experience any of these symptoms, contact your vascular access center or healthcare provider immediately for evaluation and management.
• Regular Monitoring: Regularly check your access site for these signs and symptoms and report any changes to your care team.
• Follow Care Instructions: Adhere to all care instructions provided by your healthcare team to maintain the health of your vascular access.

Preventive Measures:

• Routine Check-ups: Schedule regular check-ups with your healthcare provider to monitor the condition of your vascular access.
• Proper Hygiene: Keep the access site clean and follow all recommended hygiene practices to prevent infections.
• Avoid Strain: Avoid activities that could strain or damage the access site, such as heavy lifting or prolonged pressure.

 By staying vigilant and proactive, you can help ensure the longevity and functionality of your vascular access, thereby supporting the effectiveness of your dialysis treatments.

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Types of Vascular Access Procedures and Their Duration:

Angioplasty:

• • Duration: Approximately 10 – 30 minutes.

• • Details: Angioplasty is a minimally invasive procedure used to widen narrowed or blocked blood vessels, typically arteries. This procedure is often performed to improve blood flow in patients with vascular access issues, such as those requiring dialysis.

Declot/Thrombectomy:

• Duration: Approximately 20 minutes to 60 minutes.
• Description: A declot or thrombectomy procedure is performed to remove blood clots from an existing vascular access, such as an AV fistula or AV graft. This procedure is crucial for maintaining the patency and functionality of the access point, ensuring that dialysis treatments can continue effectively. It involves using catheters, specialized instruments, and sometimes medication to break up and remove the clot, restoring proper blood flow. Under the skilled hands of Dr. Hamid Nazeer, these procedures can be completed quickly and safely, often within 30 minutes to an hour and a half, minimizing discomfort and downtime for patients.
• A declot or thrombectomy procedure is an essential intervention to ensure that your vascular access remains functional and effective for dialysis. Dr. Nazeer’s expertise and efficiency in performing these procedures help ensure a swift and safe resolution to any access issues. If you have any concerns or need further information, please don’t hesitate to reach out to our clinic.

Percutaneous AV Fistula Creation:

• Duration: Approximately 20 – 40 minutes.
• Description: This minimally invasive procedure involves using catheters and imaging guidance to create an arteriovenous (AV) fistula without the need for open surgery. The procedure is performed through small punctures in the skin, making it a quicker and less invasive option compared to traditional surgical methods. Dr. Hamid Nazeer is one of the few doctors at access centers who can perform percutaneous AV fistula creations, ensuring that patients benefit from this advanced, efficient, and less invasive technique.
• Percutaneous AV fistula creation is a cutting-edge procedure that offers a quicker and less invasive alternative to traditional surgical methods. Dr. Nazeer’s expertise in this area ensures that patients receive the highest quality care with minimal discomfort and recovery time. If you have any questions or would like more information about this procedure, please feel free to contact our clinic.

Central Venous Catheter Insertion:

• • Duration: Approximately 10 minutes to 30 minutes

• • Details: Central venous catheters (CVC) are usually inserted into a large vein in the neck, chest, or (rarely) the groin. This is a less complex procedure compared to fistulas and grafts and can often be done on an outpatient basis.

Peritoneal Dialysis Catheter Placement:

• • Duration: Approximately 20 to 40 minutes.

• • Details: The insertion of a peritoneal dialysis catheter involves placing a catheter into the abdominal cavity. This procedure is typically performed under local anesthesia with sedation or general anesthesia, depending on the patient’s needs and Dr. Nazeer’s preference.

AV Graft Placement:

• Duration: Approximately 1 to 2 hours – typically done outside of VACI.
• Details: An AV graft involves inserting a synthetic tube to connect an artery and a vein. This procedure typically requires local anesthesia and possibly mild sedation. If a patient is not a candidate for a percutaneous AV fistula creation, an AV graft placement is an alternative option. Here’s how we approach the procedure:

• • Pre-Procedure Evaluation: The patient undergoes a thorough evaluation to assess the suitability for an AV graft, considering factors such as vein and artery quality, overall health, and specific needs.

• • Preparation: On the day of the procedure, the patient receives local anesthesia to numb the area where the graft will be placed. Mild sedation may also be administered to help the patient relax.

• • Procedure: A small incision is made to access the artery and vein. A synthetic tube (graft) is then carefully inserted to connect the two vessels. The graft serves as a conduit for blood flow, allowing for efficient dialysis.

• • Closure: After the graft is securely in place, the incision is closed with sutures. The patient is monitored during a brief recovery period to ensure there are no immediate complications.

• • Post-Procedure Care: Patients receive detailed instructions on how to care for the graft site, including keeping the area clean and monitoring for signs of infection or other issues.

Post-Procedure Considerations:

• Recovery Time: Recovery time can vary, but most patients can go home the same day for catheter insertions and may need a short hospital stay for fistula or graft placements when placed by a surgeon.
• Healing Period: For AV fistulas, it may take several weeks (typically 6 to 12 weeks) for the fistula to mature before it can be used for dialysis. AV grafts generally require a shorter maturation period, usually about 2 to 4 weeks.
• Follow-Up Appointments: Patients will need follow-up appointments to monitor the access site, ensure proper healing, and assess functionality.

What to Expect:

• Pre-Procedure Preparation: Patients may need to undergo pre-procedure testing and consultations. Instructions on fasting or medication adjustments will be provided by the healthcare team.
• During the Procedure: Patients will receive local anesthesia to numb the area, and in some cases, sedation or general anesthesia may be used.
• Post-Procedure Care: After the procedure, patients will receive specific care instructions to ensure proper healing and reduce the risk of complications. This may include how to care for the access site, signs of infection to watch for, and activity restrictions.

Conclusion:

Understanding the typical duration and what to expect from vascular access procedures can help patients prepare mentally and physically. We strive to ensure that every patient is fully informed and comfortable throughout their treatment journey. If you have any specific concerns or questions about your upcoming procedure, please do not hesitate to contact our team for more detailed information.

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1. What should I bring to my appointment? Patients should bring identification, such as a driver’s license or state ID, insurance information, a list of medications, and any relevant medical records.
2. If you have a procedure requiring sedation, you should not operate a motor vehicle for the next 24 hours following your procedure. In that case, patients may need to arrange transportation to and from their appointments with a friend or family member. Occasionally, our clinic can assist with providing transportation for appointments. Please reach out to us if this is a concern for you.
3. Lastly, if you are getting sedation, it’s important to avoid food and drink at least four hours before your appointment. Regarding medication, our medical team will speak with you directly to give specific instructions on how to proceed.

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