DFW Vascular

06/20/2026

Here we share the treatment of a 69 year old woman on hemodialysis with a clotted right arm dialysis vascular graft, she had been dialyzing using a right internal jugular dialysis catheter. During the declotting endovascular procedure we identified extensive thrombus in the central veins, axillary, subclavian, and brachiocephalic. Today, we used the Penumbra thrombo-aspiration device to remove thrombus from her central veins restablishing flow. After this procedure we declotted her dialysis graft successfully.

05/24/2026

05/24/2026

We used the supraclavicular approach to gain access to the left brachiocephalic vein in a dialysis patient with a left arm dialysis access and severe dysfunction that caused hyperkalemia. The left subclavian vein had been stented at another institution and was occluded. The patient also had occluded internal jugular veins, the traditional vein approach when the subclavian veins are occluded. The supraclavicular puncture of the left brachiocephalic vein allowed access to the central veins and placement of a HeRO conduit to bypass the subclavian vein occlusion and preserve the left arm dialysis access.

05/21/2026

First one to use the new FLEX angioplasty device at Methodist Dallas Medical Center to treat special situations of dialysis access blockages.

11/20/2025

This is a case of a 55 y/o dialysis patient new to our practice who presented with a clotted dialysis access that was considered not treatable and received a femoral dialysis catheter for dialysis at an important medical center in Dallas. We were able to discover the culprit lesion, an occluded left thoracic vein stent (Brachiocephalic vein). We performed thrombolysis of the dialysis graft and recanalization/restenting of the thoracic vein stent restoring the function of the dialysis access. The procedure was performed at our endovascular angiosuite in Duncanville, Texas. The patient went home after the procedure.

11/13/2025

This is a case of a 47 y/o on dialysis new to our practice, who has a left arm dialysis access severely dysfunctional causing severe left arm edema due to an occluded left thoracic (brachiocephalic vein) stent placed a few years ago. Previous attempts to open the central vein at other places had failed. We were able to recanalize the thoracic vein and restent it restoring its function. The procedure was performed at DFW Vascular outpatient angiosuite!

10/29/2025

During the past two days we treated three dialysis patients with subclavian vein occlusion with endovascular recanalization and angioplasty at our office base endovascular suite. These lesions cause dialysis access dysfunction and upper arm swelling and threaten the function of the dialysis access with thrombosis.

10/15/2025

This week has been about outpatient treatment of central vein stenosis in dialysis patients. It causes disabling arm edema and inadequate dialysis. These patients were treated at our office based outpatient endovascular suite under local anesthesia and sedation and were discharged to home the same day of the procedure!

04/11/2024

First “inside-out” recanalization procedure with supraclavicular stentgraft to superior vena cava and right arm dialysis graft at Cayetano Heredia Hospital! Patient had occlusion of all main thoracic veins and had been on dialysis via a groin catheter!