Dialysis Access Management

What is Dialysis Access Management?

If you have severe kidney disease or your kidneys fail, you need dialysis therapy to clean and filter your blood. Dialysis Access Management is an in-office procedure that prepares you to receive dialysis. 

Types of Dialysis Access Management

To receive dialysis, Dr. Gerges must first establish access. The I-Vascular Centers of El Paso, San Antonio, and Abilene all provide several options for Dialysis Access Management, including:

Graphic photo of an arteriovenous fistula
Surgical Arteriovenous Fistula vs. Non-Surgical Endovascular Fistula Creation

Arteriovenous Fistula (AV Fistula) is the most popular type of dialysis access, in which a connection is made between an artery and a vein to increase blood flow. However, there are both surgical and non-surgical approaches to making this connection. One type of treatment involves Dr. Gerges making a surgical connection between an artery and a vein, increasing blood flow through the vein, which helps to enlarge and strengthen it. This allows for healthy blood flow between your body and the dialysis machine.

If your veins are in good enough shape, a quicker, less-invasive non-surgical Endovascular Fistula Creation may be a suitable alternative. The Ellipsys™ Vascular System uses catheter-based technology and image guidance to create a side-to-side “pairing” of an artery and a vein using heat, pressure, and radiofrequency electrodes. The Ellipsys™ System does not require an incision or sutures, only a small needle stick, and leaves no metal or implant behind in your body.

Ellipsys™ Vascular System
Arteriovenous Graft

An Arteriovenous Graft (AV Graft) is a prosthetic that Dr. Gerges uses to connect a vein to an artery. If your veins are too small for an AV fistula, you might benefit from an AV graft. Though safe, AV grafts present a risk of infection and typically close more quickly than AV fistulas.

Graphic of an arteriovenous graft
Graphic image of a non-tunneled central venous access device

Central Venous Catheter

A central venous catheter (CVC) is a flexible plastic tube inserted into your skin through a vein in your neck, groin, or chest. CVCs are typically used in emergencies because they present a high risk of infection.

Peritoneal Dialysis

If you need to undergo dialysis several times during the day, Dr. Gerges might recommend peritoneal dialysis. This type of treatment uses a clear tube, called a catheter, to direct dialysate cleansing fluid through a small hole in your abdomen and then waste fluid is drained through the same opening.

Graphic of continuous ambulatory peritoneal dialysis

What type of Dialysis Access Management is right for me?

To determine the type of dialysis access management that’s right for you, Dr. Gerges reviews your medical history, conducts a physical exam, and asks questions about the severity of your kidney disease and lifestyle. After gathering the necessary information, he develops a custom treatment plan that aligns with your individual needs.

What if I have dysfunctional dialysis access?

Dr. Gerges can successfully treat dysfunctional dialysis access on-site, using safe and effective minimally-invasive procedures. Depending on your health history and specific needs, he might recommend one of the following treatments:

  • Angioplasty – a balloon is inflated inside of a blood vessel to expand it and increase blood flow. In some instances, once the balloon is removed, a stent may be placed inside to prevent the blood vessel from closing.
  • The MILLER procedure for Steal syndrome – the access is adjusted to the proper size to restore proper blood flow to the hand by using an angioplasty balloon and then banding the access.
  • Thrombectomy – removal of blood clots.

All of these procedures are outpatient, allowing you to return home on the same day of your appointment. Additionally, Dr. Gerges communicates results promptly to your dialysis care team, ensuring continuity of care. 

To learn more, schedule a Dialysis Access Management appointment by calling 915-855-6508 for El Paso, 210-481-9544 for San Antonio, 325-268-4040 for Abilene, or by clicking the button below.

Three Convenient Texas Locations:


Next to Davita/El Paso Kidney
11989 Pellicano Dr., Suite D
El Paso, TX 79936
Phone: 915-855-6508
Fax: 915-855-6509

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Medical Park at Stone Oak
19234 Stonehue
San Antonio, TX 78258
Phone: 210-481-9544
Fax: 210-481-9545

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Hendrick Health #1
6300 Regional Plaza, #475
Abilene, TX 79606
Phone: 325-268-4040
Fax: 325-268-4041

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