A dialysis fistulogram involves the placement of one or more plastic tube(s) (catheters) into your dialysis graft/fistula. Some numbing medicine will be injected in the skin over the graft/fistula before the catheter is inserted. Intravenous medications may also be given to you to make you more comfortable and relaxed. This is known as conscious sedation.
Once the catheter has been placed into the graft/fistula, it will be advanced through the blood vessels. During this time, x-ray contrast material (x-ray dye) will be injected through the catheter and x-ray pictures taken. You may be asked to hold your breath for several seconds as these pictures are taken. During the injection of x-ray contrast material, you may experience a warm feeling or a strange taste in your mouth. Both of these sensations are temporary and will go away soon. Depending on the results of the fistulogram, an angioplasty, stent placement, or thrombolytic therapy may be performed. At the completion of the fistulogram, the catheter(s) will be removed and pressure will be applied to the insertion site(s) until the bleeding has stopped.
If the fistulogram shows an area of blockage, an angioplasty may be performed in an attempt to open up the area. This involves the insertion of a special tube, which has a tiny deflated balloon. The balloon is positioned at the site of the blockage and is then inflated. Following an angioplasty, if there still is not enough blood flow through the area of blockage, a metal mesh tube (stent) may be placed at the site. The stent will widen the vessel and improve the blood flow.
If the arteriogram shows that a blood clot is blocking one of your vessels, a special drug or mechanical device may be used to dissolve the clot. This is known as lytic therapy.