Dialysis Access Procedures

VITA physicians are skilled in the placement and maintenance of vascular accesses for hemodialysis.


Permcatheters are tunneled central dialysis catheters that maintain many people on dialysis when grafts and fistulas are not possible. VITA physicians insert permcatheters primarily in the internal jugular veins, thereby avoiding the complications associated with other insertion sites. However, they are skilled in placement of catheters wherever other areas they may need to go. We use Palindrome brand of catheters, which are bonded with heparin (to prevent thrombosis of the catheter), and with antibiotics (to prevent infection).

Dialysis Grafts

Dialysis grafts can become partially or fully blocked over time, causing poor blood flow during dialysis. This can result in inadequate dialysis, or loss of the access. VITA physicians study the grafts with angiography, and open the blockages using minimally invasive techniques, such as balloon angioplasty, stenting, or stent-grafting. These procedures are performed as outpatients, and can significantly improve the quality of dialysis and help the graft to work better and last longer.

Dialysis Fistulas

Dialysis fistulas are the preferred method of hemodialysis access, but are the most difficult to fix when clogged. VITA physicians have devised methods to open clogged fistulas using angioplasty and stents, as outpatient procedures. Patients that would otherwise lose their fistulas can maintain the high performance and excellent dialysis afforded by the fistulas, by undergoing a short outpatient procedure with VITA physicians.