What is vascular access surgery?

Vascular access surgery is done to insert a catheter for dialysis. It may be done for the insertion of a permanent or temporary dialysis catheter.

Why would I need a dialysis catheter?

A temporary dialysis catheter is usually inserted for people who have acute kidney failure or kidney disease.

A permanent dialysis catheter is usually inserted for people who require long-term dialysis such as those with: failure of vascular access, end-stage renal disease, intolerance to haemodialysis, congestive heart failure and poor cardiac function, prosthetic valvular disease, peripheral vascular disease, drug poisonings, pancreatitis, inherited enzyme deficiencies.

How is vascular access surgery done?

Temporarily:

The site where the catheter will be inserted is cleaned thoroughly before beginning. The vein is accessed using a needle. Once threaded into the vein an x-ray is taken to make sure it is in place. Dialysis can then begin.

Permanently:

Using laparoscopic surgery, the catheter is inserted into the main artery, either in the groin or in the neck. The catheter is threaded into the artery and stitched into place before being tested with saline solution.

What will happen after the procedure?

After surgery, it is normal to feel pain in the area where the catheter was inserted and to have red skin around the wounds. Bruising and slight bleeding and oozing near the catheter is also normal.

The fluid used to test the catheter may be drained afterwards. It is essential to contact Dr Muthambi if you experience any of the following symptoms as emergency care may be needed:

• High temperature or chills
• Vomiting
• Swelling around the incisions
• Extreme pain

You will be instructed not to do any strenuous physical activity for at least four weeks after your procedure.

What are the potential risks and complications of vascular access surgery?

The risks during this procedure are rare, but the following may occur with the temporary insertion of a catheter:

• Infection of the wound or internal infection.
• Irregular heartbeat.
• Damage of the arteries and nearby veins.
• Lung collapse if the needle punctures the lung.
• Air into the bloodstream and cause an air embolism.
• A fragment of the catheter may break off and travel through the bloodstream.

A permanent catheter insertion may involve the following risks:

• Infection of the wound or internal infection
• Airway obstruction caused by bleeding
• Bleeding
• Low blood calcium levels
• Permanent hoarse voice due to nerve damage
• Risks from general anaesthesia

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