Fistulagram

A fistulagram is a diagnostic imaging exam that is done to determine if there are any problems with your arterial-venous fistula, such as blood clotting, and help your interventional radiologist plan the best treatment for you.

Procedure preparation

A nurse from CDI will contact you before to your procedure.
At this time, it will be important to review any medications you may be taking and to discuss known allergies to foods or medications.
Females in their childbearing years should let the nurse or technologist know if there is any possibility of pregnancy.
This is an outpatient facility, which means you will go home the same day your procedure is performed.
Eating: Do not eat solid food 4 hours before your procedure. You may take sips of water with medication.
Medication: Most people can continue to take their prescribed medication. If you are a diabetic, ask your doctor about modifying your insulin dose for the day of your procedure. If you take a blood thinner such as Coumadin, you must tell your doctor so that it can be stopped.
Arrive one hour before your procedure if you are receiving an I.V. for sedation.

During the procedure - what to expect

In the procedure room, you will lie down on a cushioned, x-ray bed.
You will have an I.V. put in your arm so that you are able to receive medication to help you relax.
Your fistula area will be cleaned and numbed with a local anesthetic.
An interventional radiologist will insert a needle into your fistula and inject contrast (x-ray dye) to enhance the images. You may feel warmth in your hand, arm, and chest, and may get a metallic taste in your mouth. These sensations last 10-15 seconds.
Several x-ray pictures are needed to complete the procedure. These pictures are reviewed by the interventional radiologist and, if necessary, the findings discussed with your referring doctor. During your appointment, we will correct any narrowing or clot in the blood vessel with a balloon angioplasty, stent, or a clot-breaking device. A fistulagram usually takes 2-3 hours to complete.

After the procedure – what to expect

The most common complications are infections, blockage of the fistulas, and occasionally, clotting of the blood. All can be resolved with appropriate medical care.
Once your procedure is complete, we will provide you with information on how to care for your vascular access site.
Your hemodialysis sessions will take place in a hospital’s dialysis unit or an outpatient dialysis center.

What is an interventional radiologist?

Hemodialysis procedures are all performed by interventional radiologists – physicians who are specially trained to perform minimally invasive, targeted treatments. These physicians use image-guided technology, such as fluoroscopy (x-ray) or ultrasound, to ensure accuracy and safety during your procedure.

If you have additional questions about your appointment or our services, check out our Frequently Asked Questions or contact your local CDI center.