Dialysis Access Management
South Florida Advanced Access Care in Miami, FL offers the full scope of care for patients with ESRD, and specializes in dialysis access procedures.
Dialysis Access Management
At South Florida Advanced Access Care, we are devoted to the continuing care and treatment of our End-Stage Renal Disease (ESRD) population. We work with many dialysis centers in the Miami region and will make sure that your dialysis center stays up to date on the health of your access. Whether you have an arteriovenous fistula, arteriovenous graft, peritoneal dialysis catheter, or dialysis catheter, we have the proven treatments to ensure that your dialysis access will function safely and smoothly
Vein mapping is performed to determine the diameter, length, and suitability of the superficial veins for placement of a dialysis access. At South Florida Advanced Access Care, we perform this procedure with venography using contrast dye.
Angioplasty, Stenting, and Fistula Salvage
Many poorly functioning accesses suffer from stenosis, which is a blockage or narrowing in the access. To open a stenosis, we may intervene with angioplasty and/or stent placement to improve blood flow. In angioplasty, a small balloon, mounted on a catheter, is inflated within the blood vessel, expanding the narrowed access. If necessary, we may also insert a metal stent to maintain even blood flow throughout the access. For arteriovenous (AV) fistulas that have not "matured" for optimal dialysis treatment, we can provide a series of angioplasty and/or stenting treatments to expand the access. This series of access interventions, performed over the course of a few weeks, is known as fistula salvage.
Thrombectomy and Thrombolysis
For clotted accesses, we offer thrombectomy to remove blood clots or thrombi from the access. This can be done in a variety of ways, including medications to dissolve the clot, and angioplasty to fix the cause of the clotting. Mechanical thrombectomy devices can also be used to remove the clot form the access.
Dialysis Catheter Placement and Removal
We offer dialysis catheter placements so patients can receive dialysis treatment right away. There are several types of catheters, but they are typically flexible hollow tubes placed in a vein in the chest. A catheter may be placed while a fistula or graft is waiting to mature or when there is no other dialysis access available. When you've received a functional hemodialysis arteriovenous fistula or graft or it has matured, we will also safely remove your dialysis catheter.
Peritoneal Dialysis Catheter Placement and Repositioning
Peritoneal dialysis is a process that uses the patient's peritoneum in the abdomen as a membrane across which fluids and dissolved substances are exchanged from the blood. Fluid is introduced through a permanent tube in the abdomen and is flushed out through regular exchanges. We can place the permanent tube, called a peritoneal dialysis catheter, if it is determined that this is the best method of dialysis for you.
The MILLER Procedure for Steal Syndrome
Steal syndrome is a clinical condition caused by arterial insufficiency distal to the dialysis access (area furthest away from the access). Blood is diverted into the fistula or graft and away from the hand. To correct the balance of blood flow, we offer a banding technique, the Minimally Invasive Limited Ligation Endoluminal-assisted Revision (MILLER) procedure to accurately manipulate the access to the proper size and allow for even blood flow. This procedure uses an angioplasty balloon as a sizing dowel, allowing our physicians to band accesses to their desired diameter to treat steal syndrome and high-flow accesses.
A Peripherally Inserted Central Catheter (PICC) is a long, thin plastic tube that functions as an intravenous (IV) line. A PICC line is inserted into a peripheral vein, typically in the upper arm, and advanced under ultrasound and x-ray guidance until the catheter tip terminates in a large vein in the chest. A PICC's central tip location in the body allows for treatment that could not be achieved with a standard peripheral IV access. In addition, PICC insertions are less invasive, have fewer complications, and can remain in place for a much longer duration than other types of central lines.
Implantable ports are used to facilitate long term intravenous (IV) access, for example, to administer chemotherapy for cancer treatment. The implantable port is placed under the skin and has a small reservoir attached to a catheter which connects to a vein. An implantable port may be permanent, or it may be removed if it is determined that the patient no longer requires a port for access in the near future.
South Florida Advanced Access Care
Miami, FL 33176