Methodist Hospital Metropolitan completes San Antonio's first Inside-Out® procedure using new technology

Methodist Hospital | Metropolitan is proud to have completed San Antonio's first Inside-Out® procedure using a new device. The Surfacer® System is the first and only FDA-cleared device that can assist physicians in obtaining central venous access in patients with blocked veins and was developed locally in San Antonio. This new technology and procedure are a great option for hemodialysis patients or those who have exhausted their dialysis access options.

Nearly 40 percent of patients with a central venous catheter experience a blockage, most commonly caused by a clot. For dialysis patients, this becomes an obstacle as regular central venous access is essential for their treatment. The current approach for most patients with central venous obstructions is to utilize a different vein. This approach minimizes the ability to place and mature a functioning fistula, resulting in increased catheter days and costs.

This new technique allows physicians to gain central venous access through a catheter in the patient's neck instead of their groin. A groin catheter is uncomfortable and can get infected easily or fail; this approach is a long-term, easy option. It also minimizes unnecessary access-related procedures and complications. Many dialysis patients pass away from their lack of central access options due to obstructions; this approach preserves their central vasculature, allows them to maintain their central venous system, and can prolong their life.

First performed by Dr. Gabriel Bietz, MD, Vascular Surgeon at Methodist Hospital | Metropolitan, this new approach and device are of great benefit to patients experiencing a variety of health issues. Created to allow central venous access reliably, efficiently, and repeatedly, this option greatly impacts patients who have end-stage renal disease, allowing them to have potentially longer dialysis access over their lifetime. This ultimately helps to control their hypertension and decrease their risk of stroke. Additionally, patients undergoing chemotherapy will experience an improvement in port placements through this technique.

"Many of our patients have had multiple central vein vascular access procedures during their lifetime,” said Dr. Bietz. “This approach offers additional treatment options to better serve our beloved South Texas community."

Any patient 18 years and older could be a candidate for this procedure. Patients who feel they might be a good candidate for this new procedure should contact their nephrologist, vascular surgeon, primary care provider, or oncologist.

More information about vascular care at Methodist Hospital Metropolitan