Dialysis fistula/graft declotting interventions are minimally invasive procedures performed to improve blood flow in the fistula and grafts placed in the blood vessels of dialysis patients.When fistulas and grafts become clogged or narrowed, which can prevent a patient from undergoing dialysis, interventional radiologists use two image-guided interventions to fix the problem. Then either direct local thrombolysis or Angioplasty-Stenting can be proposed depending on lesion characteristics
- Catheter-directed local intravascular thrombolysis dissolves blood clots that build up in fistulas and grafts by injecting a medicine
- Angioplasty and vascular stenting uses mechanical devices such as a balloon to open fistulas and grafts and helps them remain open. The balloon used is then removed out of the body. Sometimes a small implantable wire mesh tube called a stent may be required to keep the fistula or graft open if angioplasty alone fails
- These procedures are used to treat:
- Narrowing of dialysis fistula or grafts. When there is decreased flow or vein hyper pressure in a graft or fistula, angioplasty or angioplasty with vascular stenting may be performed
- Thrombosis of dialysis fistulas or grafts. When blood does not flow smoothly, it can begin to coagulate turning from a free-flowing liquid to a semi-solid gel, called a blood clot or thrombus. When blood clots in a fistula or graft prevent dialysis from being performed, catheter-directed thrombectomy (clot removal), or thrombolysis with clot-dissolving drugs may be performed
- Some blockages of the veins or arteries are too difficult to open with catheters and balloons. Surgery may be needed to bypass the blockage. If that is the case, a catheter may need to be placed in a neck vein to allow you to receive dialysis temporarily until a surgeon is able to fix your dialysis fistula or graft

