Vascular Access Service

One of the most important steps which must be taken before starting regular haemodialysis sessions is preparing for vascular access - this is the access point on your body where blood will be removed, cleaned and returned to the body during the dialysis sessions. We can provide temporary access for your initial dialysis sessions, but establishing long-term access allows for easier and more efficient removal and replacement of your blood with fewer complications.

The main type of vascular access is the creation of an AV fitsula, which is done by connecting an artery directly to a vein, normally in a patients' forearm during an operation under local anaesthetic.

An AV fitsula is connection between a vein and an artery in your arm. A fitsula is useful because it causes vein to grow large and strong for easy access to the blood system. The AV fitsula is considered the best long-term vascular access for haemodialysis because it provides adequate blood flow for dialysis, lasts a long time, and has a complication rate lower rate lower than any other access types. If an AV fitsula cannot be created, a synthetic graft or tunnelled venous catheter may be needed.

In most cases, the operation can be performed on a day-case basis. However in more complex cases you may need to stay in hospital. We will discuss this with you at your appointment.

Vascular Access Clinic

At CUH, we provide a one-stop vascular access clinic prior to surgery. At this clinic, you will meet a clinical nurse specialist and vascular surgeon. You may need an ultrasound scan or venogram study of your forearm prior to surgery to make sure that your veins are suitable for a fistula.

If the vascular surgeon feels that you are fit for surgery, a date for the operation will be discussed and booked in for you. This will usually be as a “day-case” which means you will not have to stay in hospital.

The one stop clinic is managed by a our clinical nurse specialist service.