Patient information

Kidney failure treatment

AV fistulas, AV fistulogram, and angioplasty

If the kidneys fail and a transplant is unavailable, then dialysis is necessary to survive. Hemodialysis (dialysis) is a process by which a machine filters blood and removes excess fluid. In dialysis, there must be an access point to your blood. One option is to surgically create a connection between your artery and vein directly (AV fistula) or using a small tube (AV graft). A vascular surgeon typically performs this procedure.

After creation of an AV fistula, it is important to closely monitor this access point. Using a special x-ray called a fistulogram, an interventional radiologist can evaluate the AV fistula to see if there is a concern for a narrowing or blockage. The physician makes a small puncture in the blood vessel, injects a special dye, and then takes an x-ray to observe blood flow through the fistula. If a narrowing is present, the interventional radiologist can expand the vessel with an angioplasty, a treatment that uses a small balloon that is expanded to relieve the narrowing.