Fistulogram

This leaflet explains what will happen when you come in to hospital for a Fistulogram. It explains what is involved and what the possible risks are.

It is not meant to replace informed discussion between you and your doctor, but can act as a starting point for such discussions. If you have any questions about your procedure, please ask the doctor or renal access nurse who referred you, or the relevant department.

What is a Fistulogram?

A Fistulogram is an examination of the blood vessels that make up your fistula / graft.

A small needle is placed in your fistula / graft and dye (contrast agent) is injected. This dye provides an image (like a map) of your blood vessels that would otherwise be invisible on x-ray.

Why do I need a Fistulogram?

Your doctor / dialysis nurse feels that there may be a problem with your dialysis fistula / graft. This test is the best way to diagnose this problem.

You may already have had an ultrasound scan or transonic on dialysis to assess the flow in your fistula, to help decide how to approach this problem.

Who has made the decision?

Your renal doctor, the renal access nurse, and the interventional radiologist will have discussed your care and feel this is the most appropriate next step. However, you will also have the opportunity for your opinion to be considered, and if after discussion with your doctors you no longer want the procedure you can decide against it.

What are the risks to having a Fistulogram?

A Fistulogram is a very safe procedure, but there are some risks and complications that can happen.

• Very occasionally a small bruise can appear at the site of the needle puncture.

• Less commonly, ongoing bleeding in this area leads to a short stay in hospital (this happens in one out of every 100 cases).

• Very rarely damage to the fistula can happen that may need further treatment by a interventional radiologist or a small operation.

• The risk of infection is very low.

Do I need to stop any medication before my procedure?

You should take your normal medication on the day of your procedure, unless you are given specific instructions by staff.

Do I need to make any special preparations before my procedure?

A Fistulogram is performed during an outpatient appointment. You will be asked to come to the Renal Outpatient Department (please see your appointment letter for more details).

If you have any allergies or have previously had a reaction to the dye (contrast agent), please call the renal access team on 01227 864305 at least a week before your procedure. We will need to give you medicine to reduce the risk of an allergic reaction and use a different dye.

How long will it take?

Every patient is different, but expect to be in the department for one hour. There may be a delay if urgent cases take priority on the day.

Who will I see?

You will be seen by a specially trained team led by an interventional radiologist. They have specialised expertise in reading the images and using imaging to guide catheters and wires to help with diagnosis and treatment.

Where will my procedure take place?

You will have your procedure in the theatre department, where specialised x-ray equipment has been installed.

What happens during my procedure?

You will be asked to lie down and the skin over the area of your fistula / graft will be swabbed with an antiseptic. A needle, often followed by a fine plastic tube, will then be placed in your fistula / graft and dye injected.

You will be asked to hold your breath for a few seconds while the images are taken.

Will it hurt?

The needle insertion may cause a little discomfort, similar to that of having a blood test taken.

What happens after my procedure?

To prevent bleeding, light pressure is applied for a few minutes to the area where the needle / plastic tube was placed. You can usually go home 30 minutes after a Fistulogram.

Your Fistulogram results will be discussed with your renal doctor. Your renal access nurse will telephone you to let you know if you need any further procedures, such as a Fistuloplasty.

Is it safe to have this procedure before / after haemodialysis?

Yes, the procedure will not interfere with your haemodialysis treatment.

What if I have any questions or concerns?

If you have any questions or concerns, please contact the Renal Dialysis Access Team on telephone 01227 864305, Monday to Friday 8am to 4.30pm.