Dialysis and Venous Access Management

Doctors at Advanced Vascular Associates and Vein Care Center provides the latest and most effective vascular access services including Fistulas, Grafts, Catheters. Call (973) 755-9206 today to schedule a consultation.

At Advanced Vascular Associates, we combine medical excellence, state-of-the-art technology, and a compassionate, team-based approach to quickly diagnose and treat your condition.

KIDNEY FAILURE SERVICES

For patients’ whose kidneys are severely diseased, we offer dialysis access services. Our fistula rates are among the highest in the country and we have received numerous awards for our dialysis access care.

When a patient’s kidneys are unable to filter their blood effectively, hemodialysis may be deemed necessary. When performing dialysis, your vein doctor will use a machine called a dialyzer. This machine will perform like the function of the patient’s kidneys by filtering their blood. In dialysis access, a doctor creates an easy-to-access entry site in the patient’s bloodstream. Often placed under the skin in their arm, leg, or chest, it enables quick, safe, and easy flow of blood to and from the body during dialysis. Dialysis removes waste and excess minerals, such as salt and potassium, from the patient’s blood, and helps to control their blood pressure. Blood moves to and from a tube from the patient’s body to the dialyzer. The dialyzer filters their blood and then it returns to their body through another tube. At Advanced Vascular Associates, we offer the full range of dialysis access and dialysis access management, including:

  • Fistulas
  • Grafts
  • Catheters

Some common questions that patients ask our vein doctors include:

Where is a hemodialysis catheter placed?

Your hemodialysis catheter will be placed in one of your large veins. A very common site that vein doctors will utilize is the superior vena cava or SVC. A catheter will be placed by your vein doctor, he/she will puncture the internal jugular vein in the neck. This is mostly done on the right side of the neck. Your doctor will then place the catheter downward towards the chest. Alternatively, an SVC catheter can also be inserted via subclavian veins. However, this route is an inferior option to most vein doctors because the groin area is more prone to infections and also because the patient will not be able to sit upright.

What is the difference between grafts and fistulas?

Our vein doctors often get asked what the difference between an AV graft and an AV fistula. Both, however, are different types of hemodialysis access. The A, which stands for artery and the V for vein. Therefore, there is some connection between an artery and a vein. The hemodialysis machine needs a faster flow than a vein can provide, but not necessarily as fast as an artery.

An AV fistula is a direct connection between the patient’s artery and one of the nearby veins. This is actually the absolute best option for gaining access that a patient can have, because it is using all of their own tissue. The fistula also resists clotting and infection.

An AV graft, which is also on occasion called a bridge graft, is an indirect way to create a connection between the artery and a vein. In this case, a plastic tube is most commonly used, but on occasion a donated cadaver artery or vein can be used.

How long does a dialysis graft last?

The hemodialysis graft is often times ready to use about 3 weeks after the patient’s surgery. However, AV grafts are usually not as long lasting as AV fistulas, but if the patient cares for the graft well, it can last for several years.

ADDITIONAL SERVICES YOU MAY NEED

Office Hours

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

8:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed

  • "One of the most professional and accommodating office and doctors I have been to in a very long time. I saw Dr. Lee and found him to be very kind and knowledgeable. He diagnosed a blood clot, got me started on a blood thinner and I feel better than I have in months. Thank you, thank you, thank you!"
    Barbara B.
  • "Best vascular surgeons around Dr. Patel is the best"
    Cookie R.
  • "Dr.Lee is thee BEST Vascular Surgeon I EVER had in 42yrs! He is kind, compassionate, funny, and super honest! I really need the super honest part as his patient because I have been on dialysis for almost 20yrs time around and then dealing with end-stage renal failure since I was 13 and I was born with circle kidney so I need someone who is going to be upfront and honest with me and compassion at the same time and he is the ONLY surgeon to get three fistulas working on me! No one in 42 years has ever done that! He is the best surgeon I have ever had! Omg... and his staff is phenomenal !"
    Mercedes R.
  • "Dr. Patel placed my fistula in july of 2014 and I have had most of my maintenance fistulagrams done by Dr Raiz. Though whoever i have had have been great.The entire staff is wonderful . They are compassionate caring and professional. Would not go anywhere else."
    Sherry S.
  • "Dr Riaz, Dr Lee, and the entire Medical Staff at Advanced Vascular Associates are one of the most professional, knowledgeable, courteous, and caring Medical Teams that I've ever visited in my life! I have the greatest amount of respect for them, and trust that whatever the purpose of your visit is, you will leave knowing that you've been treated by the best! Thanks for taking good care of me (especially Rose)."
    Bruce B.
  • "My Dad had surgery for a AAA a year ago! He is 91 years young! Dr. Lee brings so much to the Operating Table!I have never been put more at ease than by Dr Lee. His reassurance and soft-spoken confidence made me rest easily during the Procedure. What a great Man!"
    Lisa V.
  • "Dr. James and the staff are the best. Very attentive and caring."
    Roseanne L.
  • "My first time there. Everyone was very nice and Dr. Patel was awesome! Would recommend to everyone."
    Helen A.
  • "Caring and professional nurses and staff. And special thanks to Dr. David Cohen. His expertise and compassionate level of treatment is beyond comparison."
    Edward B.
  • "The advanced vein care center headed by Dr. Cohen, my physician, is a superior center with caring hands. Each and every visit has been a comfort to me."
    Theresa P.
  • "Thank you for always doing your very best for Dad. We appreciate you always doing what was best for Dad and for always making him feel worthy of being treated as a breathing human being and not some ‘old sick man’."
    The Danielian family
  • "A note of thanks to you! I must say I have never been more pleased with the care and treatment rendered by you and your staff, as compared to countless other physicians and their somewhat lacking care and consideration for their patients’ time and well-being. I am doing fine and had very little discomfort!"
    Paula D.
  • "Thank you very much for the great attention and services offered not only to me, but also to my assistant. Your loving and caring is taken to heart."
    Gustavo G., D.M.D.