what is dialysis access?
Patients with dialysis fistulas have unique needs. The flow through the fistula must be maintained above a certain level to allow adequate hemodialysis. The fistulas can be monitored with Doppler and color-flow ultrasound to determine if a narrowing (stenosis) is developing or if a clot is forming. In some cases, a fistulogram (injection of contrast through a needle or catheter) may be necessary to fully diagnose the problem.
Should a problem exist with a fistula, a Radiologist can often diagnose and fix the problem without the need for an additional operation. Using angiographic techniques with balloon dilation (angioplasty), a narrowing in a fistula can often be opened before the fistula clots. Occasionally, the lesion maybe elastic in nature that may require a stent placement to keep the vessel open.
If the fistula has already clotted off, it can often be de-clotted with interventional radiology techniques. The narrowed area which caused the clot to form can then be dilated with an angioplasty balloon. These techniques do not always work, but in many cases the patient saves a trip to the operating room or the need for a dialysis venous catheter.
How should I prepare?
- You should continue medications prescribed by your doctor unless informed otherwise.
- Women should always inform their technologist if there is any possibility of pregnancy.
If you require sedation for your procedure, observe the following instructions:
- Do not eat or drink anything after midnight the day before the exam.
- Take all your usual medications including blood pressure and heart medications.
- You may have a small sip of water to swallow your medications.
- If your procedure is scheduled for 10:30a.m. or later, you may have a clear liquid breakfast. This includes coffee, water, and juices you can see through, but no solid food.
- Transportation: Be sure to make arrangements for someone to drive you home after your procedure. If you receive sedation, please do not operate machinery or vehicle for 24hrs following procedure.
Special instructions for diabetic patients:
- Light breakfast
- Half of insulin dose
- If you take Glucophage, do not take medication day of procedure
How do i get the results?
After your study is over, the images will be evaluated by one of our board-certified Radiologists with expertise in Interventional Radiology. A final report will be sent to your doctor, who can then discuss the results with you in detail. Should you have any questions regarding your procedure, we will be happy to discuss them with you.