Dialysis Access & AV Fistula Surgery: Expert Vascular Care

Dr. Hamdallah specializes in advanced and complex access surgery techniques.

The Vascular Lifeline: Expert Creation and Maintenance of Dialysis Access


When you or a loved one faces kidney failure and requires hemodialysis, establishing reliable, long-term access to the bloodstream is the first critical step. As specialized vascular surgeons, we focus on creating and maintaining a durable dialysis access—your lifeline—to ensure safe, efficient, and complication-free treatment.

Why is a Vascular Surgeon Essential for Dialysis Access?


A successful dialysis access depends entirely on the health of your blood vessels. Vascular surgeons possess the deep knowledge of anatomy and advanced surgical skills required to:
Map and Assess: Perform detailed pre-operative vascular ultrasound mapping to identify the best artery and vein.
Create the Access: Surgically connect vessels with the highest chance of long-term success (e.g., creating a functioning AV Fistula).
Manage Complications: Perform timely maintenance and repair procedures, such as angioplasty and stenting, to keep the access functioning.

The Three Types of Dialysis Access (Fistula, Graft, and Catheter)


The choice of access is crucial for your long-term health and is always made based on the principle: Fistula First, if possible.

1. The Gold Standard: Arteriovenous (AV) Fistula Creation

This is the preferred, most permanent type of dialysis access.
Procedure: A direct surgical connection between your native artery and vein (typically in the arm).
Benefit: The lowest rates of infection and clotting, offering the longest functional lifespan. Requires a maturation period of 2-3 months before the first use.

2. Alternative Access: Arteriovenous (AV) Graft

Used when a patient’s natural veins are unsuitable for a fistula.
Procedure: A synthetic, biocompatible tube is used to bridge the connection between the artery and vein.
Benefit: Ready for use quickly (often within 2-3 weeks).

3. Temporary Access: Dialysis Catheters

Used for urgent dialysis needs or while a permanent access site is maturing.
Procedure: A flexible tube placed into a large vein, usually in the neck or chest.
Warning: Due to the highest risk of infection and central vein damage, we work diligently to transition patients to a permanent AV fistula as quickly as possible.

Dialysis Access Care and Complication Management


Protecting your access is key to maintaining your quality of life. Common issues managed by our vascular team include:


Clotting (Thrombosis): We offer rapid, minimally invasive procedures like Thrombectomy to remove clots and restore blood flow to save the access.
Stenosis (Narrowing): We use Angioplasty and Stenting to widen the narrowed vessel segment.
Infection: Prompt medical and surgical management to treat the infection before it compromises the access.


If you feel the “thrill” (vibration) over your AV fistula or graft is gone, contact us immediately. Loss of the thrill indicates a potential blockage and requires emergency vascular intervention.

Schedule Your Dialysis Access Consultation

If you are preparing for hemodialysis or need evaluation for a failing dialysis access site, schedule a consultation with our expert vascular surgery team today. We are committed to providing you with the best chance for a successful, long-lasting AV fistula.

Book a Consultation