Procedures We Perform

Carolina Vascular Access provides specialized “access care”, with a focus on the following interventional procedures:

  • Declot/Thrombectomy – Utilizes medication placed into the patient’s graft or fistula to dissolve clots that have formed. Clots can also be extracted by the physician from the site.
  • Angiogram/Fistulogram – A contrast agent is injected through the graft or fistula to determine the cause of the blood flow problem. When a stenosis or narrowing has been found, this procedure may require an angioplasty and/or a stent.
  • Angioplasty – A balloon catheter is inserted through the graft of fistula and inflated to dilate the narrowing.
  • Stent Placement – This involves placement of a metallic stent to hold open a blood vessel and is placed after an angioplasty.
  • Tunneled Dialysis Catheter Insertion – Catheter is placed in one of the veins in the neck or leg.
  • Tunneled Catheter Exchange – Replacement of a catheter for a new or different type of catheter. This may also involve an angioplasty if catheter had been malfunctioning.
  • Tunneled Dialysis Catheter Removal – Removal of catheter when no longer needed.
  • Temporary Catheter Insertion – This catheter is usually placed in the femoral vein and is removed after dialysis.
  • Vein Mapping – This procedure uses IV dye to see and picture the veins in the arms and chest, to help plan the placement of a new graft or fistula.
  • Peritoneal catheter insertion, manipulation and removal.

Reasons For Procedures


Reasons for this study may be related to the following:

  • Difficulty cannulating the access
  • Increased venous pressures on dialysis
  • Excessive negative arterial pressure on dialysis
  • Prolonged bleeding after dialysis
  • Inability to achieve adequate blood flow on dialysis
  • Decrease in thrill and bruit
  • Steal Syndrome: hand below access cold, painful, or numb

Catheter Placement or Exchange

Catheters have more complications than fistulas or grafts and sometimes must be removed or exchanged. Some reasons for this are:

  • Infection
  • Clotting in the catheter tip
  • Exposed Cuff (the cuff that adheres the catheter to the surrounding tissue becomes exposed to the outside)
  • Damage (puncture or crack in the catheter)
  • Recirculation of blood while on dialysis

What to Do Before Your Procedures

Pre-OP Instructions

Carolina Vascular Access Referral Form (PDF)