Deepak Sharma, M.D.
Medical Director - Midwest Nephrology Vascular Access Center
A good access is very important for dialysis and ultimately overall
health of patients with kidney failure. Occasionally, access problems can
occur. A blockage or narrowing in the vascular access can limit the blood
flow and make dialysis treatments impossible or less effective. At
the Midwest Nephrology Vascular Access Center, procedures are performed
which extend the life of an access without surgery, avoiding missed dialysis treatments.
A fistulogram is needed to ensure a fistula or graft is functioning properly.
A small needle is placed into the access and dye is injected. X-rays are taken
to see if there is a blockage. If a blockage is found, the doctor may stretch
it with a balloon. This is called an angioplasty. He may also choose to place
a stent (a wire tube), which keeps a narrowed area in the vessel open.
A declot is necessary when a patient's vascular access has completely stopped working.
The doctor will place two needles into the access to remove the clot and start the
blood flow through the access again.
A dialysis catheter insertion is performed when a patient does not have a vascular access,
or the doctor can't fix an access that has stopped working. The doctor usually places
the catheter into a vein in the chest or leg. An x-ray camera is used to make sure
the catheter is positioned properly.
A dialysis catheter exchange is done when a person's catheter fails to function properly.
The doctor will use the x-ray camera to remove the old catheter and place a new one in the same area.
A catheter removal is performed when a patient's permanent vascular access (fistula or graft) is working well
and being used. The catheter will also be removed when a patient no longer requires dialysis treatments.
If you need a vascular access procedure, here is some important information you should know.
The length of your procedure may be anywhere from one to four hours. Most patients require a local
anesthesia and receive some sedation through an IV. Therefore, you would need someone to drive
you home. We also recommend that a family member or friend stay with you for several hours after
you return home.
Generally, you will be asked to not eat or drink for five hours before your procedure. You should
however, take your blood pressure medicines with small sips of water. If you are a diabetic, you
should not take your diabetic pill. You will receive instructions if you are on insulin. If you
take Coumadin (Warfarin) you will also receive instructions regarding stopping the dose.
If you have an allergy to contrast dye you will receive a prescription for a special medicine to avoid any reactions.
If you suspect you are pregnant, notify the Vascular Access Center before your procedure.
If you are unsure about any of your pre-procedure instructions, please call: