Dialysis Access Conditions | Orbis Vascular

Dialysis Access Conditions & Vascular Health

Dialysis access is essential for life-sustaining hemodialysis. When problems occur—such as stenosis, thrombosis, or catheter malfunction—they must be diagnosed and treated quickly to maintain reliable treatment. At Orbis Vascular, we specialize in minimally invasive procedures to restore blood flow, protect your access, and keep dialysis running safely and smoothly.

Vascular Access Stenosis

Narrowing within a fistula or graft that slows blood flow, leading to poor dialysis and access failure.

Read more about vascular stenosis

Stenosis occurs when scar tissue, vessel thickening, or previous needle use causes the fistula or graft to narrow. This reduces blood flow and increases pressure during dialysis.

Common warning signs

  • Low blood flow during dialysis
  • High venous pressures on the machine
  • Prolonged bleeding after dialysis
  • Decreased thrill or vibration in the access
  • Arm swelling or redness

Why treatment is important

Untreated stenosis is the #1 cause of dialysis access thrombosis (clotting). Early diagnosis and angioplasty can reopen the narrowed segment and prevent complete access failure.

Treatment options

Angioplasty, stent placement, and specialized balloon treatments can restore optimal flow and protect long-term function of the fistula or graft.

Access Thrombosis

A complete blockage of the fistula or graft, requiring urgent de-clotting to restore flow.

Read more about access thrombosis

Thrombosis occurs when a clot forms inside the access, completely blocking blood flow. This stops dialysis immediately and requires same-day treatment.

Symptoms & signs

  • No thrill or vibration in the access
  • Pain, swelling, or firmness along the arm
  • Dialysis machine alarms for low or no flow
  • Sudden inability to use the access

Why this is an emergency

Without quick intervention, the clot can permanently damage the access. Most thrombosed fistulas and grafts can be successfully opened with urgent thrombectomy.

Treatment

Options include catheter-directed clot removal, mechanical thrombectomy, clot-dissolving medication, and angioplasty to correct the underlying stenosis that caused the clot.

Dialysis Access Failure

When an access point (fistula or graft) stops working effectively and needs urgent repair or replacement.

Read more about access failure

Access failure occurs when a fistula or graft can no longer provide adequate blood flow for dialysis. This can happen gradually (stenosis) or suddenly (thrombosis).

Signs of access failure

  • Repeated dialysis machine alarms
  • Low blood flow despite adjustments
  • Prolonged bleeding after cannulation
  • Weak or absent thrill
  • Changes in the appearance of the access

Why fast evaluation matters

Early intervention can often save the access. Without treatment, patients may require a temporary catheter, which carries higher infection risk.

Treatment options

Angioplasty, revision procedures, thrombectomy, or new access creation may be recommended depending on severity.

Catheter Malfunction

Inability to pull or return blood through a hemodialysis catheter, often requiring immediate attention.

Read more about catheter malfunction

Catheter malfunction occurs when one or both ports of the hemodialysis catheter fail to draw or return blood adequately. This can interrupt or severely slow dialysis.

Symptoms

  • Inability to initiate dialysis
  • Poor flow rates despite repositioning
  • Frequent machine alarms
  • Pain or pressure near the catheter site

Common causes

  • Fibrin sheath formation around the catheter
  • Catheter tip migration
  • Clot buildup inside the catheter
  • Line kinking or mechanical obstruction

Treatment options

Evaluation may include catheter exchange, fibrin sheath removal, thrombolytic medication, or repositioning using imaging guidance to restore proper function.

Trouble With Your Dialysis Access?

If your fistula, graft, or catheter is not functioning properly, rapid evaluation can prevent loss of access and keep dialysis safe and effective.

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