What is Diaylsis 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.

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 and the need for a dialysis venous catheter.