A dialysis fistulagram is a procedure performed when your dialysis graft or fistula is not working properly, usually due to a stenosis or narrowing in a blood vessel. Many patients will need this procedure 2 or 3 times in a year. If these problems are not treated early, the dialysis access can clot and a procedure is needed to remove the clot and fix the underlying problem, this is known as a declot.
What should I expect?
You will be in a procedure room that looks similar to an operating room with an x-ray camera in the center. Patients usually receive moderate sedation for the procedure, you will not need general anesthesia. After numbing up an area over your access, your radiologist will access your fistula and inject dye. If there are any areas which are narrowed, your radiologist will open them up with a balloon. This may be painful, and you will receive medication for this. Rarely, a device known as a stent will be placed. If there is a clot within the fistula, your radiologist will need to break up the clot with a device or medication.
What are the alternatives?
Though problems may be diagnosed with ultrasound, if there is a problem with your access, the only other alternative is to have surgery where a new access would need to be placed.