Why choose DAI for your patients?

• Availability of same day surgery
• State-of-the-art surgery facility
• All dialysis access procedures offered
• Experts in the field of dialysis access
• Dedicated to training and education
• DAI is on the forefront of clinical trials

Same Day Surgery Available

At the Dialysis Access Institute, we can evaluate your patient, determine the best access possible, and complete the surgery/procedure all in the same visit.

Call us directly at 803-395-2145 to schedule an appointment.

State-of-the-Art Facility

The DAI is a free standing outpatient surgery center connected to the Regional Medical Center. It was established in March of 2011 and has continued to increase its annual procedural numbers since it opened with the following features:

• 16,000-square-foot facility
• 6 Operating/procedure suites (4 of which have live video streaming capabilities)
• 6 Pre-op stations
• 6 Post-op stations
• Digital radiology equipment
• Hemodynamic monitors in each room
• Spacious, comfortable waiting room
• Covered canopies at both patient drop-off and ambulance entrances
• Total emergency back-up power throughout the facility
• Dedicated triage and surgery suit for COVID patients

Dialysis Access Procedures Offered

HEMODIALYSIS

Percutaneous fistula creation:

DAI was one of the first facilities in the country to offer the percutaneous fistula technique. The following two techniques create an anastomosis between deep arteries and veins in the forearm and rely on flow reaching the superficial veins through the perforating or deep communicating vein. No surgical incision is required.

• WavelinQ device is an endovascular technique used to create an anastomosis between the ulnar or radial artery and adjacent vein.
• Ellipsys system is a technique to percutaneously create an anastomosis between the proximal radial artery and the perforating vein.

Open fistula creation:

• Radio-cephalic
• Brachiocephalic
• Brachio-basilic (both single and two-staged technique)

GRAFT PLACEMENT

At DAI we offer various types of grafts for both upper and lower extremities including grafts needed for immediate access, to avoid dialysis catheter placement.

HeRO® graft placement:

The HeRO® graft is a fully subcutaneous vascular access system that bypasses the central venous system to provide reliable, continuous blood flow directly from a target artery to the heart.

DAI is currently the only facility in South Carolina that places the HeRO® graft. At DAI we place approximately 75 HeRO® grafts annually. Dr Ross was one of the pioneers with HeRO® grafts and to date has inserted over 1,500, making him the global leader in this procedure. DAI was the initial site for HeRO® graft clinical trials.

The HeRO® graft is indicated in patients with central venous stenosis (CVS) or venous outflow obstruction that are:

• Catheter-dependent or approaching catheter dependency
• Failing fistulas or grafts due to central venous stenosis

Benefits of the HeRO® graft include:

• Fewer infections - 69% reduced infection rate compared with catheters
• Superior Dialysis Adequacy - 1.7Kt/V, a 16% to 32% improvement compared with catheters
• High Patency Rates - Up to 87% cumulative patency at 2 years
• Cost Savings - A 23% average savings per year compared with catheters

PERITONEAL DIALYSIS

At DAI we offer both percutaneous and laparoscopic peritoneal dialysis (PD) catheter placement techniques, along with the ability for immediate use of the PD catheters for dialysis. Averaging over 200 laparoscopic placements and revisions annually, DAI is one of the leading centers in the country for the number of laparoscopic PD catheters placed.

We adopt the latest advanced laparoscopic techniques to reduce PD catheter dysfunction, which includes:

• Trans-rectus muscle tunneling of the PD catheter
• Omentopexy
• Lysis of adhesions
• Catheterpexy

In addition, we offer:

• Sub-sternal and sub-costal extension catheters predominantly for morbidly obese patients
• Placement of the PleurXTM Catheter System for patients with recurrent ascites
• Temporary and permanent dialysis catheter placement
• Repair and revisions of problematic accesses

ENDOVASCULAR PROCEDURES

Endovascular procedures include:

• Thrombectomy of clotted fistula’s, grafts, and HeRO® grafts
• Angiogram and angioplasty procedures
• Treatment of central venous occlusion or stenosis

Experts in the Field of Dialysis Access

Dr. John Ross, FACS, FASDIN
Dr. Mark London, DAI Medical Director
Dr. Jackson Ewart, MD
Dr. Jalal Hakmei
Dr. John Aruny
NP Leigh Jacobs
Anesthesia
Ultra-sonographers
Radiology Technicians
Nurses and scrub Techs

Dedication to Training and Education

The DAI is only one of ten accredited facilities in the United States by the American Society of Diagnostic & Interventional Nephrology as a hemodialysis vascular access training center.

Accordingly, the DAI provides educational programs for physicians, nurses, and technologists regarding dialysis access, both on site and through live video streaming, so that best practices can continue to be developed and reviewed for the patients.