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For patients on dialysis due to kidney failure, a fistula (the artificial joining of an artery and vein) is often created to provide access for dialysis. Over time, this fistula can become blocked or clogged and need to be cleaned out in order to restore blood flow and continue dialysis. A Fistulagram is a procedure that uses a special X-ray to help identify which of these blood vessels are narrowed or blocked. Once the vessel is open, angioplasty with or without vascular stenting may be performed to keep it open.
Your physician may recommend a Fistulagram if you are receiving dialysis and your fistula (artificial joining of an artery and vein) becomes clogged or narrowed, preventing you from having effective dialysis.
During a Fistulagram, an Interventional Radiologist will use a special X-ray to locate the area(s) where blood vessels may be narrowed or blocked. Once the area is identified, balloon angioplasty may be performed to open up the blood vessel(s) and increase blood flow.
You will be given detailed instructions by our staff before your procedure. In general, do not eat, drink or smoke anything after midnight the night before your procedure. This includes breath mints, gum and tobacco. Patients should notify staff if they are diabetic, taking anticoagulants (blood thinners) or allergic to anesthesia. Be sure to bring your insurance card, photo ID, list of current medications (dose and frequency) and any diagnostic testing results.
Prior to the procedure, you will receive specific instructions on how to prepare and what medications, if any, you should avoid. During the exam, you will lie on a table. You will be connected to monitors that will track your vitals during the procedure and you will have a clip on your finger to make sure you are receiving enough oxygen. You will be given a mild sedative or anesthesia. A contrast agent will be used to provide a clear picture of the blood vessels. The area where the skin nick will be made will be sterilized and numbed. A catheter will be inserted into your fistula and blood thinners may be injected. A series of X-rays will be taken of the fistula to determine if there are any blockages and where they are located. If necessary, a balloon angioplasty and/or vascular stent may be placed at the area of blockage to keep the vessel open. Pressure will be applied to the area and a bandage will be placed over the incision site.
You will feel a slight sting when the needles are inserted for the IV line and the anesthesia. If you receive sedation, you will feel relaxed and sleepy and may or may not be partially awake during the procedure. You may feel some pressure when the catheter is inserted, but no serious pain.
After the procedure, you will need someone to drive you home. You should relax when you return home and avoid any strenuous activity. You may resume normal activities the next day and may drive after 24 hours.
Before scheduling an appointment, you will need to get a referral from your physician. Once you have a referral, you can schedule an appointment by calling 703.698.4475 Monday through Friday 7am to 5pm.