CONDITIONS

Vascular access

WHAT IS VASCULAR ACCESS?

Vascular access procedures refer to the “insertion of a catheter” into the blood vessel or abdomen or the “creation of a fistula or graft” which serves as a lifeline or connection for the patient. These connections to your bloodstream enable you to receive your medication, nutrition and dialysis easily. The creation of vascular access is done by a vascular surgeon such as Dr Moydien, who has experience with the delicate veins and blood vessels and expertise in vascular surgery.

WHEN IS VASCULAR ACCESS NEEDED?

A simple intravenous (IV) line is effective for short-term use but is not suitable for long-term use. Vascular access is typically needed for patients who are ill and may need long term medication or nutrition intravenously or patients with chronic kidney disease needing dialysis. Vascular access can last weeks, months or even years.

Vascular access is typically placed for patients in need of frequent, longer-term:

  • Intravenous antibiotics
  • Medications
  • Drawing of blood samples
  • Long-term intravenous feeding or nutrition
  • Chemotherapy (referred to as chemo-ports)
  • Haemodialysis (a ‘lifeline’ for patients with chronic kidney disease)
  • Blood transfusions
  • More functional IV lines
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TYPES OF VASCULAR ACCESS

There are different types of vascular access procedures depending on your specific needs and requirements.
Temporary vascular access:

  • Insertion of a temporary (non-tunnelled) catheter
  • Peripherally inserted central catheter (PICC) line

Permanent vascular access:

  • Insertion of a permanent (tunnelled) catheter
  • Insertion of a peritoneal dialysis (PD) catheter
  • Creation of an arteriovenous fistula (AVF)
  • Creation of an arteriovenous graft (AVG)

A catheter is a special thin soft flexible tube that is placed in the vein, allowing access to your bloodstream without the need for repeated skin punctures and needles. For longer-term access, the catheter is tunnelled partially or implanted completely beneath the skin to decrease the risk of infection. Temporary or permanent catheters are usually inserted in the neck, upper chest, arm or groin. Peritoneal dialysis (PD) catheters are inserted into the abdomen. Arteriovenous fistula (AVF) and arteriovenous grafts (AVG) are usually created on your non-dominant lower arm or upper arm, and less frequently on your leg.

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