dialysis access angioplasty
WHAT IS dialysis access angioplasty?
Dialysis Access Angioplasty is designed to improve blood flow in fistulas and grafts, the artificial blood vessel connections used to facilitate kidney dialysis.
WHAT ARE THE RISKS OF DIALYSIS ACCESS ANGIOPLASTY?
• Injury to the wall of the artery or vein.
• Bruising or discoloration may occur at the site. Although rare, heavy bleeding from the catheter site may occur.
TELL YOUR HEALTHCARE PROVIDER IF YOU:
• Are pregnant or think you may be pregnant. Radiation exposure during pregnancy may lead to birth defects.
• Are allergic to or sensitive to any medications, contrast, latex, tape, or anesthetic medicines (local or general).
• Have kidney failure or other kidney problems. In some cases, the contrast can cause kidney failure. You are at higher risk for this if you take certain diabetes medicines. You may need to hold certain medications prior to the procedure.
• Are taking any medication that include prescriptions, over-the-counter, and herbal supplements.
• Have a bleeding disorder or take blood thinners, aspirin or medications or supplements that affect blood clotting. These may have to be stopped prior to the procedure.
HOW DO I GET READY FOR A DIALYSIS ACCESS ANGIOPLASTY?
• You may need to have blood work prior to your procedure. You should receive an order from your physician.
• You may be asked not to eat after midnight prior to the procedure. You may have clear liquids 2 hours before your arrival time.
• Bring your insurance card and picture ID with you to the appointment. You may bring an adult guest with you.
• You will need a driver to your appointment. If you need transportation, please let the office know so that we can arrange it for you.
WHAT HAPPENS PRIOR TO DIALYSIS ACCESS ANGIOPLASTY?
• You will read and sign your consent that gives your permission for the procedure to be performed. You will have the opportunity to ask your provider questions and have anything explained that you do not understand .
• You will be asked to remove any clothing or jewelry that may get in the way of the test. You will be given a gown to wear. You will be asked to empty your bladder prior to the test.
• An intravenous (IV) line will be started in your hand or arm. You will be connected to a monitor that records your heart rate, blood pressure, and breathing.
• You may get medication to help you relax before the procedure.
WHAT HAPPENS DURING DIALYSIS ACCESS ANGIOPLASTY?
Your skin will be cleansed in the arm with the dialysis access. The skin will be injected
with a local pain medication to numb the area.
A Certified Moderate Sedation nurse monitors you 1-on-1 during your procedure. You will receive anesthesia that allows for conscious sedation. The medication will make you feel
very relaxed and alleviate any pain. You may drift to sleep. You will not be intubated and
can breathe comfortably and unassisted. Supplemental oxygen is used during anesthesia.
Tell the physician or nurse if you experience any trouble breathing, sweating, numbness or
A catheter will be placed in the artery in your access arm and special imaging, called and angiogram, will be done to visualize the vessel and determine the location of any blockage(s). Pictures will be taken of the blood flow in and around your fistula or graft using fluoroscopy. When contrast is injected, you may feel a warm, flushing sensation, salty or metallic taste, a brief headache, or nausea. These effects usually last for a few moments.
The catheter will be advanced to the area of narrowing. Once in place, a balloon at the end of the catheter will be inflated, pushing any blockage against the interior walls of the vessel. This widens the diameter of the vessel and restores increased blood flow. Sometimes, a tiny mesh tube, called a stent, is inserted and expanded in the vessel. The stent serves as an internal support to help keep the vessel open. The balloon is deflated and removed from the access. these procedures are included in the consent form as treatment possibilities.
Once the procedure is completed, the physician will remove the catheters. Pressure will be
applied to the site to keep it from bleeding. Manual pressure will be used to close the
puncture site. After the bleeding stops, a dressing will be applied on the sites.
WHAT HAPPENS AFTER DIALYSIS ACCESS ANGIOPLASTY?
• You will be taken to the recovery room. A nurse will watch your vital signs and the access
site(s). They will check the circulation and sensation in your extremities.
• Depending on the closure device used, you will be discharged after a period of rest and no signs of bleeding.
• You will be encouraged to drink water and fluids to help flush the contrast from your body.
• You will receive written discharge instructions about returning to your daily activities and how to care for your bandage and incision site.
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