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.

WHY MIGHT I NEED dialysis

 access angioplasty?

 

You may need dialysis access

 angioplasty if the connections

become clogged or narrow.

Stenting may be needed. Dialysis

 may only continue once this

issue has been corrected.

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

heart palpitations,

 

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.

AT HOME

 

• Once home, you should watch the

 injection site for bleeding. A small

 bruise is normal. So is an

occasional drop of blood at the

site.

 

• You should watch your arm or leg

for changes in temperature, color,

pain, numbness, tingling, or loss of

 movement.

 

• Drink plenty of fluids to help the

 contrast leave your body. You may

 not be able to do any strenuous

 activities or take a bath or shower

for a period of time after the

procedure.

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