Dialysis Shunt Maintenance/Repair

A dialysis shunt, also known as a fistula or graft, is a surgically created connection between an artery and a vein. This is done to provide a location for dialysis needle access. Through repeated use, scarring can develop within the shunt resulting in narrowing. Blood clots may develop within the shunt resulting in total blockage. If this occurs, a dialysis shunt angiogram is performed where x-ray dye, or contrast, is injected via a small catheter into the shunt and x-ray pictures obtained to create a map of the shunt and nearby blood vessels. The angiogram typically takes under 1 hour to complete and the patient is given a local anesthetic prior to insertion of the catheter. If a narrowing is seen, an angioplasty/stent can be performed. If blood clots are present, thrombolytic therapy can be performed.

Preparation:

1. Arrange for a family member or friend to drive you home. No food or drink for 4 hours prior to exam time. Medications may be taken with a small amount of liquid up to exam time.
2. Patients who are diabetic and are on Glucophage should not take Glucophage on the day of the exam and should consult their physician before restarting the medicine.
3. Please consult with your doctor about whether or not to take certain medications such as Insulin. Bring all of your medications with you.

After Discharge:

1. Limit activity for at least 24 hours after the examination.
2. Patient will be given care instructions upon discharge from the hospital.

Notify Your Doctor If:

1. You notice bleeding or enlarged lump at site where the catheter was inserted.
2. Increasing pain of the insertion site.
3. Arm pain or numbness.
4. Arm swelling.