Vascular & Endovascular
Dialysis Access Creation & Maintenance
Dialysis access procedures create or repair the AV fistula or graft used for hemodialysis. Regular maintenance keeps the access working, prevents clotting, and helps patients avoid missed dialysis sessions and hospital visits.
AVERAGE PROCEDURE TIME
45 to 90 minutes
Anesthesia
Sedation with local
Recovery
Same day, 2 to 4 hours
Ride home
Required if you receive sedation
Overview
Reliable access is the lifeline of hemodialysis. We create, mature, and maintain AV fistulas and grafts so treatment runs on schedule.
Maintenance procedures such as angioplasty and declotting keep a struggling access working and prevent emergency catheter placement.
Is this right for me?
Candidacy is confirmed after a review of your history, imaging, and medications. Patients we most often treat include those with:
- New or planned start of hemodialysis
- Low flows, high venous pressures, or prolonged bleeding after dialysis
- A clotted fistula or graft
- A fistula that has not matured for use
What to expect, step by step
Arrival and preparation
You check in with a coordinator, change into a gown, and meet your nurse. Vitals are taken, an IV is started if needed, and your care team reviews the plan and answers questions with your caregiver present.
Access evaluation
Ultrasound and a fistulogram identify narrowing, clot, or maturation problems.
Treatment
Angioplasty opens narrowed segments, thrombectomy removes clot, and stents are used only when needed.
Recovery suite
You rest in a private recovery bay while your nurse monitors vitals and comfort. Written instructions are reviewed with you and your caregiver before discharge.
Home the same day
A caregiver drives you home. A member of our team calls the next business day to check on you and confirm your follow-up appointment.
Recovery
Most accesses can be used at the next scheduled dialysis session.
Report arm swelling, loss of thrill, or bleeding immediately.
Risks and what we watch for
Every procedure carries risk. These are the ones we discuss most often for this procedure.
- Bleeding, bruising, or soreness at the access site or incision
- Infection, which is why sterile technique and, when indicated, antibiotics are used
- Reaction to sedation, anesthesia, or contrast dye, monitored continuously by your anesthesia provider
- Incomplete relief of symptoms, or symptoms that return over time
- The need for additional treatment, imaging, or a different procedure
- Rarely, a complication serious enough to require a higher level of care than an outpatient setting provides
We review these with you in detail before you consent, and you can change your mind at any point.
Coverage note
We verify your benefits and give you a written estimate before scheduling.
Prepare for this procedure
- Before your surgery
- The day of your procedure
- Anesthesia and sedation
- Recovery at home and when to call
Frequently asked questions
Will I miss dialysis?
We schedule around your dialysis days so treatment continues without interruption whenever possible.
How often will maintenance be needed?
It varies. Routine surveillance detects problems early and reduces urgent visits.
Is dialysis access care done as an outpatient procedure?
Yes. It is performed at our ACHC-accredited ambulatory surgery center in The Woodlands, minutes from Tomball and Spring, and patients go home the same day with a caregiver.
Will my insurance cover it?
Coverage depends on your specific plan and benefits. Our team verifies your benefits and gives you a written estimate before anything is scheduled.
Do you offer Spanish-speaking support?
Yes. Bilingual English and Spanish coordination is available from your first call through recovery instructions and follow-up.
