Dialysis Fistula/Graft Declotting Interventions at Sky Ridge Medical Center

Dialysis fistula/graft declotting interventions are minimally invasive procedures performed to improve blood flow in the fistula and grafts placed in the blood vessels of dialysis patients.

Dialysis is a process used to treat patients whose kidneys are not working properly. It involves a special machine and tubing that removes blood from the body, cleanses it of waste and extra fluid and then returns it back to the body.

In order to undergo dialysis, a physician first creates access to a patient's blood vessel using one of three methods:

  • A fistula, which is made by joining together an artery and vein to make a bigger high-flow blood vessel.
  • a graft, in which a soft plastic tube is placed between an artery and a vein, creating an artificial high-flow blood vessel.
  • Catheter access, in which a narrow plastic tube is inserted into a large vein in the neck.

When fistulas and grafts become clogged or narrowed, which can prevent a patient from undergoing dialysis, interventional radiologists use two image-guided interventions to fix the problem:

  • Catheter-directed thrombolysis, which dissolves blood clots that build up in fistulas and grafts by injecting a medicine.
  • Angioplasty and vascular stenting, which uses mechanical devices, such as a balloon, to open fistulas and grafts and helps them remain open with a small implantable wire mesh tube called a stent.

Common Uses of Dialysis Fistula/Graft Declotting Interventions

These procedures are used to treat:

  • Narrowing of dialysis fistula or grafts. When there is decreased flow in a graft or fistula, angioplasty or angioplasty with vascular stenting may be performed.
  • Thrombosis of dialysis fistulas or grafts. When blood does not flow smoothly, it can begin to coagulate, turning from a free-flowing liquid to a semi-solid gel, called a blood clot or thrombus. When blood clots in a fistula or graft prevent dialysis from being performed, catheter-directed thrombolysis with clot-dissolving drugs may be performed.