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What is Vascular Access, Anyway?

November 17, 2016

Recently, we had the chance to participate in the 2016 Association of Vascular Access Scientific Meeting (AVA). We always love getting to speak with the great nurses and doctors and as we spoke with some at AVA, we realized that members of our community may be interested in learning more about what vascular access really means.

In general, vascular access procedures allow medical providers to easily access the veins of a patient’s body. Surgeons can use an AV fistula, AV graft, or PICC line or Temporary Venous Catheter for more temporary access.  These vascular access methods can be used on both adults and children and may be used for IV antibiotic treatment, chemotherapy, long-term IV feeding and blood transfusions.  Prolonged vascular access can be beneficial to the patient because it avoids countless repeated needle punctures, providing a less painful way for patients to receive long-term treatment.

An AV fistula is created by a vascular surgeon and is a connection of an artery to a vein for dialysis.  The arteries help to carry blood from the heart to the body while the veins do the opposite, carrying blood from the body back to the heart. The AV fistula tends to be placed in the forearm or upper arm, where it causes both extra pressure and blood to flow into the vein. The larger vein makes for easier and more reliable access to blood vessels.  An AV fistula helps to provide sufficient blood flow for dialysis, lasts longer than other types of vascular access, and is less likely to get infected or cause blood clots.  However, the AV fistula frequently requires at least two to three months to mature before it could be used for hemodialysis

The AV graft is a second vascular access method that many healthcare providers turn to if an AV fistula is not an option. The AV graft is a looped, plastic tube that connects the artery to a vein.  A graft can also be a man-made blood vessel used to help connect the artery and vein together.  The graft is usually ready to be used two to three weeks after the surgery.  One risk of using a graft is that it is more prone to infection and clotting than an AV fistula because it is a foreign object in the vessel.  Blood clots can develop and block the flow of blood through the graft, but if well cared for a graft can last several years.

For more temporary vascular access, a PICC line is often used.  A PICC line is a special type of catheter (a thin hollow plastic tube) that allows vascular access for IV treatments such as antibiotics, chemotherapy, and pain medications.  PICC stands for Peripherally Inserted Central Catheter and refers to the fact the catheter is placed peripherally (in an arm vein) with the tip of the catheter located centrally, as in a central vein in the body.  PICC lines are placed when patients need IV treatments for a duration of weeks to months.  

A Temporary Venous Catheter is also a more temporary form of vascular access.  A tube that inserted into the vein in the neck, chest, or leg near the groin, a Temporary Venous Catheter is only used for short-term hemodialysis.  Once the tube exits the body it is split into two tubes that have caps connecting the line that carries blood to the dialyzer and the blood back from the dialyzer to the body. Venous catheters are not suggested for long term use, as they can cause blood clots, infection or even vein scarring that causes veins to narrow. However, this method allows immediate hemodialysis which is necessary in some urgent cases.

There are many risks associated with vascular access which may lead to prolonged treatment or even surgery.  Common problems with vascular access include the potential for infection and blood clots which could reduce blood flow.  Both infection and low blood flow tend to happen more frequently in AV grafts and Temporary Venous Catheters than in other methods of vascular access.  Low blood flow caused by AV grafts may require an angioplasty to widen the narrow veins.  Temporary Venous Catheters are most likely to cause clotting problems and infection, but antibiotics are often used to prevent infection. Other medication such as Warfarin or other blood thinners may be used to keep blood from clotting in the catheter. 

There are many ways for patients to take care of vascular access devices and protect themselves while receiving treatment.  One of the most important ways is to make sure that the healthcare provider checks regularly for signs of infection or other problems.  Patients must also keep the vascular access sites clean at all times and follow the guidelines for care given by their healthcare providers.  Looking out for redness, being careful not to bump or cut the line, avoiding heavy lifting and avoiding applied pressure to the site can help ensure that complications do not occur.  Patients should also avoid wearing both jewelry and tight clothing as well as sleeping with the access arm under the head or body.  Maintaining breathability and visibility is important for caring for a vascular access site and preventing complications.  Our PICC line covers were designed with these guidelines in mind and provide an antimicrobial, comfortable, washable option and a mesh window for maximum breathability and visibility.  

We are committed to providing products that help patients with vascular access feel comfortable and care for their access sites.  We are always excited to share more on topics that interested you, so please reach out to us at wecare@careandwear.com with suggestions.

 



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