Information for patients form the Interventional Radiology Team and the Renal Dialysis Access Team
This leaflet will inform you about having a Fistulogram procedure. It will explain what is involved and what the possible risks are.
It is not meant to replace informed discussion between you and your doctor, but can act as starting point for such discussions. If you have any questions about the procedure please ask the doctor or renal access nurse who has referred you or the relevant department.
What is s Fistulogram?
This is an examination of the blood vessels that make up your fistula/graft. A small needle is placed in your fistula/graft and dye (contrast agent) is injected. This dye provides an image (like a map) of the blood vessels that would otherwise be invisible on x-ray.
Why do you need a Fistulogram?
Your doctor/dialysis nurse feels that there may be a problem with your dialysis fistula/graft. This test is the best way to diagnose the problem associated with your fistula/graft. You may already have had an ultrasound scan or transonic on dialysis to assess the flow in your fistula to help decide how to approach this problem.
What are the risks of a Fistulogram?
Fistulograms are very safe procedures but there are some risks and complications that can occur.
- Very occasionally, a small bruise can appear at the site of needle puncture.
- Less commonly, ongoing bleeding in this area leads to a short inpatient stay(one out of every hundred cases)
- Very rarely damage to the fistula can occur that may require further treatment by the interventional radiologist or a small operation.
- The risk of infection is low.
Who has made the decision?
Your renal doctor, the renal access nurse and the Interventional Radiologist will have discussed your care and feel this is the most appropriate next step. However, you will also have the opportunity for your opinion to be considered and if, after discussion with your doctors, you no longer want the procedure you can decide against it.
Do I need to stop any medication prior to the procedure?
Normal medication should be taken on the day of your procedure but specific instructions will be given in your appointment and by your nurse if you take warfarin.
Are you required to make special preparations?
Fistulograms are performed as an outpatient appointment and you will be asked to attend Renal Outpatient department. (Please see your appointment letter)
If you have any allergies or have previously had a reaction to the dye (contrast agent), you must tell the radiology staff before you have the test.
How long will it take?
Every patient is different; however, except to be in the department for one hour. There may be a delay if urgent cases take priority on the day.
Who will you see?
A specially trained team led by an interventional radiologist, they have specialized expertise in reading the images and using imaging to guide catheters and wires to aid diagnosis and treatment.
Where will the procedure take place?
In the theatre department ,where specialized x-ray equipment has been installed.
What happens during the procedure?
You will be asked to lie down and the skin over the area of your fistula/graft will be swabbed with n antiseptic. A needle, often followed by a fine plastic tube, will then be placed in the fistula/graft and dye injected. You will be asked to hold your breath for few seconds while the images are taken.
Will it hurt?
The needle insertion may cause a little discomfort similar to that of having a blood test taken.
What happens after the procedure?
Light pressure is applied for a few minutes to the area where the needle/plastic tube was placed to prevent bleeding. You can usually go home 30 minutes after a Fistulogram from the renal outpatient department. Your Fistulogram results will be discussed with your renal doctor. Your renal access nurse will inform you and explain if any further procedures such as fistuloplasty are required. You will be notified by telephone.
Is it safe to have the procedures before/after haemodialysis?
Yes, the procedure will not interfere with the haemodialysis treatment.