Case report: A PICC line-associated central occlusion complicating a brachiocephalic fistula. A 72-year-old right-handed female patient was seen for dialysis access. She was dialyzing via a right IJ permacath for three months, had a BMI of 33, and had adequate vessels for a left brachiocephalic fistula, though the vessels were smaller and deep. There was no history of previous left arm swelling, left sided permacath, READ MORE…
This transposed basilic fistula was created in one stage from a 5mm basilic vein. Although there is disagreement amongst vascular access surgeons about whether basilic transpositions should be done in one or two stages (the moving and tunneling of a vein to a new position under the skin is traumatic, and the veins do better after the move if they are larger and tougher after READ MORE…
Nothing has created more confusion recently than the subject of buttonholes in dialysis access, and nothing is more untrue than the oft-expressed misconception that “Dr. Webb doesn’t like buttonholes”. In fact, Dr. Webb likes well-created buttonholes in appropriate patients. They can be very helpful in patients with borderline deep fistulas. They can also be dangerous, and lead to loss of an otherwise well-functioning fistula, or READ MORE…
It’s time for you to tell US what YOU want! Fenton/Owosso? Genesse County? Southfield/Detroit? Livonia Andiamos? Dr. Webb has given 39 dinner talks to the dialysis community since 2010 – at Fishbones and the Whitney in Detroit; Andiamos, the Fairlane Club and elsewhere in Dearborn, The Earle and Vinology in Ann Arbor; D’Edourdos and the Redwood Inn in Grand Blanc; the Holly Inn and the READ MORE…
Michigan Vascular Access, PC, is pleased to announce the launch of our new website, “drmarcwebb.com” Material from our previous website, “michiganvascularaccess.com” has been included, but updated, and expanded greatly to include “FAQS” (frequently asked questions), Powerpoint presentations, Medical photos, and preliminary versions of our “Vascular Access Glossary”, and “Patient Primer”. Print-ready informational documents on “Risks of Access Surgery”, “Digital Ischemia”, “The Warnings Signs for Grafts READ MORE…
Years ago, I was asked if I would be willing to see children who needed dialysis access. I was reluctant, as you could imagine, but eventually came to the conclusion that I didn’t know who else to send them to. I was stuck, and thus began a challenging but rewarding aspect of my practice and development as a surgeon. Children have small blood vessels. The READ MORE…
Brief History of Presentations As a very busy, dedicated vascular access surgeon working in Southeastern Michigan since 2000, I have spoken at many different kinds of venues about all kinds of topics, and to audiences ranging from dialysis technician students to surgeons, from medical billers to industry representatives. But the most significant talks I give are to dialysis unit nurses and technicians, because that is READ MORE…
“Ultrasound-assisted digital photo diagramming of problem fistulas” After an arteriovenous fistula is created, it must “mature“, and when it is judged mature it is released for use. For many patients, this begins a difficult period in which the dialysis personnel “learn” the fistula. During this process, the patient may experience infiltration, difficult cannulation and frustration. After a number of difficult cannulations it is not READ MORE…
This is a slide presentation on the maturation of fistulas.
Learn about the different types of access types.
