HOW SHOULD I PREPARE FOR THE PROCEDURE?
You will receive instructions from staff at the interventional radiologist's office at least a day before the procedure. Make sure to let the staff know if you have any allergies to medications or to contrast material which may be used during this procedure. If you are on any blood thinners such as Aspirin, Coumadin, Lovenox, Heparin, or Plavix please let the staff know. You may have blood drawn for pre-procedure testing at either the hospital or clinic. Staff will advise you if changes in your regular medication schedule are necessary. You will be asked to avoid eating or drinking anything for six hours before the procedure. Make sure someone will be available to drive you home afterwards.
HOW DOES THE PROCEDURE WORK?
A fistulogram is the injection of contrast into your arterial/venous fistula in order to visualize the fistula using enhanced x-ray imaging. If the AV fistula has tightening (stenosis) the radiologist may do an angioplasty using an inflated balloon. A catheter is passed alongside the blockage and the balloon is then inflated which expands the wall of the vessel which will increase the flow of blood.
A stent may be placed at the site of the blockage to hold the vessel open. If the radiologist identifies a clot in the fistula he may remove the clot by angiolysis (a technique used to suck the clot from the fistula).
HOW IS THE PROCEDURE PREFORMED?
The Interventional Radiologist will inject a local anesthetic into your arm at the site of the AV fistula. Your fistula with then be accessed by the insertion of one or two needles into the fistula. The radiologist will then inject contrast (dye) through the needles that have been placed in the fistula. Several radiological images (special x-rays) will be taken of the area. If there is tightening or blockage seen then the radiologist may proceed with angioplasty or stenting of the area.
WHAT WILL I EXPERIENCE DURING THE PROCEDURE?
An IV will be started prior to the procedure. Your arm will be positioned on an arm board extended away from your side. Your arm will then be washed with a betadine scrub and covered with a sterile drape.