Assessment and Intervention of Hemodialysis Fistula and Graft

Read this information so you understand the procedure and its risks. Please ask questions about anything you do not understand.

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What is a dialysis fistula or graft intervention?

There are two types of permanent vascular access for dialysis: arteriovenous (AV) fistula and arteriovenous (AV) graft. A surgeon creates an AV fistula by connecting an artery directly to a vein, most commonly in the forearm. Alternatively, a surgeon creates an AV graft by connecting an artery to a vein using a synthetic tube or graft.

Sometimes the blood flow from an AV fistula or AV graft becomes too low due to a narrowing, a blood clot, or the formation of a collateral (accessory) blood vessel that is diverting blood flow.

An interventional radiologist can correct these problems with fistula intervention or graft intervention.

How is the procedure performed?

Using live X-ray (fluoroscopy) for guidance, the doctor will insert a catheter (a tiny tube) into a vein or artery, usually in the arm or leg, and guide it to the fistula or graft.

Then one of three things will happen:

What risks are associated with the procedure?

The procedure is considered low-risk. However, potential complications include:

Will my child be awake for the procedure?

No. Depending on your child’s medical history, we will give either intravenous sedation or general anesthesia.

What happens after the procedure?

Your child will be taken to a recovery room and in some cases may be admitted to the hospital for observation. Your child might have some mild discomfort; you may give over-the-counter pain medication if permitted by your primary physician.

When can my child bathe?

The bandage must stay dry and in place for 48 hours. You may sponge-bathe your child during this time, as long as the bandage stays dry. After 48 hours you may remove the clear bandage and gauze and your child can take a shower or take a bath, as long as the site isn’t immersed in water. Leave the Steri- Strips® (white strips) in place. Do not immerse the site in water until the Steri-Strips fall off. If they haven’t fallen off after seven days, you may remove them.

Are there any activity restrictions?

Your child may return to normal activity as tolerated.

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Contact us immediately if your child experiences any of the following :

  • weakness, numbness or swelling of the treated arm or leg
  • fever higher than 101° Fahrenheit
  • bleeding or drainage, such as pus, from the site

Call Interventional Radiology
between 8 a.m. and 4:30 p.m., Monday through Friday, at
215-590-7000. At the first prompt push 1 and at the second prompt push 2.

At all other times, call 215-590-1000 and ask to speak to the interventional radiologist on call.