Fistulogram Description

A dialysis fistulogram is a procedure where a small catheter (similar to an IV) is placed in a dialysis access (fistula or graft), IV dye is injected into the access and pictures are taken with an X-ray machine to evaluate blood flow through the access site. This is performed to detect narrowed or blocked areas in the access which would limit blood flow through the access and interfere with normal hemodialysis treatments. The catheter is removed at the end of the procedure.

This is an outpatient procedure that is done at our Indiana Surgery and Vascular Center. It is performed by one of our board certified Interventional Nephrologists. During this procedure, you may be given conscious sedation – medicine that allows you to be conscious yet relaxed while minimizing or eliminating pain, anxiety or discomfort.

If the fistulogram shows problems such as a stenosis (narrowing) or blockage, a further procedure such as angioplasty or insertion of a stent, may be performed at that time to open up the narrowed or blocked area.

Stents

Stent placement is an outpatient procedure done at our Indiana Surgery and Vascular Center and is performed by one of our board certified Interventional Nephrologists. Since these procedures are typically done following a fistulogram, you will already be under conscious sedation. This means that we give you medicines enabling you to be conscious, yet relaxed, and to minimize or eliminate pain, anxiety or discomfort.

Angioplasty Description

An angioplasty is performed immediately following a fistulogram when it is determined that there is a narrowing (stenosis) or blockage in a patient’s dialysis access (fistula or graft).

A stenosis or blockage can limit blood flow through the access, and this can cause inadequate dialysis treatments or access failure. A special tube with a tiny deflated balloon is inserted and positioned at the narrowed or blocked site. The balloon is inflated to open the affected site, and then the balloon is deflated and removed to allow improvement in blood flow. If blood clots are found within the dialysis access, the blood clots can be broken up into small pieces and removed either using medications or a mechanical device during the angioplasty procedure.

Angioplasty placement is an outpatient procedure done at our Indiana Surgery and Vascular Center and are performed by one of our board certified Interventional Nephrologists. Since these procedures are typically done following a fistulogram, you will already be under conscious sedation. This means that we give you medicines enabling you to be conscious, yet relaxed, and to minimize or eliminate pain, anxiety or discomfort.

Catheters

Catheters Used For Kidney Dialysis

A catheter is a flexible tube the size of a drinking straw that is inserted into a large vein. A catheter is often used with patients who need to start dialysis immediately or don’t have veins suitable for a fistula or graft. Due to risk of infection, catheters should be used only until a permanent fistula or graft can be placed or when there are no other options for a dialysis access.

The tip of the catheter is placed in the heart. The other end (the tail) is “tunneled” under the skin and comes out of the body. Tunneled catheters are most commonly placed in the neck or chest area.

The catheter is placed surgically by one of our Interventional Nephrologists under moderate sedation. Hemodialysis can begin immediately following catheter placement if necessary.