Dialysis access maintenance
What are interventional radiology procedures for dialysis?
Interventional radiology (IR) plays a crucial role in the management of dialysis access for patients with kidney failure. Here are some common interventional radiology procedures related to dialysis:
Creation of Arteriovenous Fistula (AVF): While this is typically a surgical procedure, interventional radiologists can sometimes assist in the creation or optimization of AVF using image guidance.
Placement of Dialysis Catheters: Temporary or permanent catheters can be placed using ultrasound or fluoroscopy for immediate dialysis access, especially in patients who cannot have an AVF or graft.
Balloon Angioplasty: This procedure is used to treat stenosis (narrowing) of an existing dialysis access site, such as a fistula or graft, improving blood flow for dialysis.
Stent Placement: In cases where balloon angioplasty alone is not sufficient, stents can be placed to maintain patency of narrowed areas in dialysis access.
Thrombectomy: This procedure involves removing blood clots from occluded dialysis access sites to restore functionality.
Revision of Dialysis Access: Interventional radiologists can perform procedures to revise or repair malfunctioning access sites, ensuring adequate dialysis.
These procedures are minimally invasive and guided by imaging techniques, which can help reduce recovery time and complications compared to traditional surgery.
What challenges can occur with hemodialysis access?
Access Thrombosis: Blood clots can form in the access site, blocking blood flow and requiring intervention.
Stenosis: Narrowing of the blood vessels can occur, reducing blood flow and necessitating procedures to open the access. This can also result in prolonged bleeding or poor fistula performance.
Maturation Issues: Fistulas may take time to mature properly, and if they don’t, alternative access methods may be needed.
Regular monitoring and care are essential to address these issues promptly and maintain effective hemodialysis. We can help treat and manage these issues.
What is hemodialysis ?
Dialysis is a medical treatment that performs the function of the kidneys when they are unable to filter waste products and excess fluids from the blood effectively and is often necessary for individuals with chronic kidney disease or acute kidney injury and can help manage symptoms, maintain health, and improve quality of life.
Hemodialysis involves circulating the blood through a machine called a dialyzer, or artificial kidney, which filters out toxins and excess fluids before returning the cleaned blood to the body. This treatment typically occurs in a dialysis center several times a week.
Tunneled catheter on the right. This goes underneath the skin with the tip terminating within the heart for optimal blood circulation through the dialysis machine.
Areas of narrowing causing decreased circulation of blood during hemodialysis.
Improved flow after repairing the area of narrowing with a balloon during a procedure called venoplasty.
