Interventional Radiology - Hemodialysis Access

RIMA Interventional Radiologists are frequently requested to intervene and assist in the salvage and treatment of vascular access routes created for hemodialysis.  AV (arteriovenous) fistulas are recognized as the preferred access method for dialysis. Fistulas are initially created by vascular surgeons by joining an artery and vein together. Since this bypasses the capillaries, blood flows rapidly through the fistula. Fistulas are usually created in the non dominant arm and may be situated in the hand, the forearm, or the elbow.  Fistulas can be narrowed or completed occluded.  In these cases, which are often emergencies, Interventional Radiologists can utilize a variety of techniques to intervene and reopen the communication.

AV (arteriovenous grafts) are much like fistulas except that an artificial vessel is used to join the artery and the vein.  Grafts are inserted when the patients native vasculature does not permit a fistula. AV grafts are at increased risk to develop narrowings, especially in the vein just downstream from where the graft has been sewn to the vein. Narrowing can lead to clotting and thrombosis.  All of these complications can be treated by interventional radiologists.

Interventional Vascular Procedures: Interventional Oncology Procedures: