Vascular access is the Achilles heel of patients treated with hemodialysis, plasmapheresis and other methods. Complications of vascular accesses are the most common cause of morbidity in hemodialysis patients, and their management in the United States consumes half of the cost of the dialysis program.

Our Center, one of the largest in Europe and so far the only one in the Czech Republic, provides for the establishment of vascular approaches, their surveillance (surveillance) and complications treatment. She is also personally connected with the Cardionephrological Counseling Center to deal with the conditions between nephrology and cardiology. Patients from all over the Czech Republic come for examination and treatment. Various grant projects dealing with vascular access problems have been repeatedly solved within the Center, and many dozens of expert reports have been published in international journals. The Center also runs postgraduate related education.

The Center employees are members of the Committee and the Audit Committee Czech Society for Vascular Access and international Vascular Access Society.

The Vascular Access Center includes 5 VFN sites:

• II. Surgical Clinic - Cardiovascular Surgery
  initiation and short-circuit, surgical treatment of complications
  Contact: +420 224 962 721
• Radiodiagnostic Clinic
  percutaneous treatment of stenoses (even under ultrasonographic control) and hand ischemia
  Contact: +420 224 962 780
• Clinic of Nephrology
  hemodialysis, peritoneal dialysis, dialysis catheters
  Contact: +420 224 962 660 | vladimir.tesar@vfn.cz | jana.lachmanova@vfn.cz
• III. internal clinic - endocrinology and metabolism
  ultrasonographic examination and in short circuits, carotid arteries, central veins, peripheral vessels, echocardiography
  Contact: +420 224 962 949 | echo1@vfn.cz
• Cardionephrology center
  clinical examination by nephrologist (Department of Nephrology) and cardiologist (2nd or 3rd internal clinic) + echocardiography.
  Contact: +420 224 966 230

Some situations - simplified clinical advice on first contact

Clinical suspicion of stenosis and short-circuit (high venous pressure, increase in recirculation,…): directly angiography (Radiodiagnostic Clinic).

Hand ischemia with short circuit: ultrasonographic examination + vascular surgeon examination.

Choice of vascular access in complicated patients: echocardiography, nephrologist and vascular surgeon examination.

Permanent Dialysis Catheters: to start a dialysis program for newly arrived patients until "maturation" and short-circuit, as a bridging solution if it is not possible to use AVF for complications, eventually. discontinuation of peritoneal dialysis - transient inclusion in HD program after their use as a long-term or definitive vascular access for HD needs.