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Diagnosis / AV Fistula Stenosis

A fistula used for hemodialysis is a direct connection of an artery to a vein. Once the fistula is created it is a natural part of the body. During treatment a nurse or a technician will place two needles into the access; the needles are connected to soft tubes that go into the dialysis machine. Your blood goes to the machine through one of the tubes, gets cleaned in the dialyzer, and returns to you through the other tube.

This is the preferred type of access because once the fistula properly matures and gets stronger; it can provide an access with good blood flow that can last for decades.

What Causes Stenosis?

Over time an access may develop a stenosis or narrowing, which can slow the blood flow. The high pressure flow of blood through the needle into the access can cause the inside of your access to become smaller or narrower.

How to Keep Your Access Working

Your dialysis care team will check your access often to ensure it is functioning well. An access that is not working well over time can decrease the amount of dialysis you receive. Your dialysis care team will teach you how to check your fistula or graft daily. The following are tips you can use to help keep a fistula or graft working:

  • Pulse or thrill – check the blood flow several times a day by feeling the vibration in the access, if you notice a change contact your doctor or dialysis center.
  • Do not wear tight clothes or jewelry on your access arm.
  • Do not carry anything heavy or put pressure on the access.
  • Do not sleep with your head on your access arm.
  • Do not let anyone use a blood pressure cuff on your access arm.
  • Do not let anyone draw blood from your access arm

IVC’s Treatment Options

Over the past 2 decades, interventional radiologists (IRs) have increasingly been involved in evaluation and treatment of malfunctioning and occluded hemodialysis access. The multidisciplinary management of dialysis access coordinated among IRs, vascular surgeons, and nephrologists has proven very effective in prolonging the patency of the vascular access and improving outcomes for patients with chronic kidney disease.

At IVC we offer several minimally invasive procedures to improve or restore blood flow in fistulas of dialysis patients. A Fistulagram, which is a procedure used to study a dialysis fistula in order to detect problems such as clots or narrowing; Angioplasty and Stenting, which can be used to expand and open the vein or artery wall; Catheter-directed thrombectomy or thrombolysis, which uses either a mechanical device or a medication to dissolve the clot.

If you have a dialysis fistula and are experiencing decreased flow due to narrowing or blood clots, call IVC today at 503-612-0498 to schedule an appointment.

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