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Treatment / Fistulagram


A fistula is a passage from your kidney used to perform kidney dialysis. A fistulagram is an x-ray procedure to look at the blood flow and check for blood clots or other blockages in your fistula.

When is a Fistulagram required?

Once kidney function goes below 10-15% of normal function, the blood fills with toxins and fluids, endangering the patient. At this point, dialysis treatments or a kidney transplant becomes necessary. Dialysis treatment replaces the kidney’s function by cleaning the blood and draining excess fluids from the body.

The use of arteriovenous (AV) fistula for dialysis is considered the best option. Compared to other types of access, AVF dialysis has lower complication rates and is less prone to infection or blood clotting.

If your fistula is not working appropriately, your doctor may refer you for a fistulagram to look for abnormal areas in your dialysis graft or arteriovenous fistula. Common issues are as follows:

  • Blocked veins or arteries (occlusion)
  • Abnormal narrowing (stenosis)
  • Areas of abnormal enlargement (pseudoaneurysm)

What to Expect from the Procedure

A fistulagram is a minimally invasive procedure where your vascular and interventional radiologist will use image guidance to place a small tube called a catheter in your graft. Contrast dye will be injected and x-rays will be taken to locate any blockage or narrowing.

The physician will also measure the pressure in the graft because high pressures can mean there is a significant narrowing. If an area of abnormal narrowing is seen, it is usually treated by placing a small balloon in the graft and stretching the narrowed area open (angioplasty). If the angioplasty is not successful, you will be referred to a surgeon for a graft revision. Sometimes a small metal tube called a stent may be placed to help keep the narrowed area open.


A fistulagram is typically performed as an outpatient procedure and lasts about an hour. Afterwards you will rest in a recovery area for a while before you are sent home or to dialysis. Most patients can resume normal activities the next day.

* This information about Fistulagram was reviewed by Dr. Jason R. Bauer. If you have any questions, please don’t hesitate to contact us using the form below.

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We are announcing that Interventional and Vascular Consultants will be closing as of March 10, 2023.

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Jason Bauer, MD RVT
Michael Pfister, MD RVT

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