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What is a fistulagram?

A fistula is a passage from your kidney that allows kidney dialysis. A fistulagram is an X-ray procedure to look at the blood flow and check for blood clots or other blockages in your fistula.

Why is it necessary?

Blood clots or blockages may interfere with your dialysis. The fistulagram helps the doctor find any blockages.

How is it done?

The radiologist places tiny tubes, called catheters, in your fistula, much like what occurs during dialysis. The doctor then injects special dye so it can be seen on X-rays.

Before the procedure:

  • You must not to eat or drink anything after midnight the night before the study except for your normal medications.  Your doctor or nurse will tell you if you should stop taking any of your medications prior to the procedure.
  • You need to bring a list of all your medications with you to the hospital. 
  • Please tell the doctor if you think you may be pregnant.
  • A nurse will place an IV in your hand or arm so that you can receive fluids and medications.
  • Your doctor will answer your questions and ask you to sign a consent form. 

During the procedure:

  1. You will lie on an x-ray table with machines all around you. You will have a blood pressure cuff on your arm, a clip on your finger to make sure you are getting enough oxygen, and wires on your legs and arms to check your heart rate.
  2. The nurse will give you pain medication and a sedative, which will help you relax, before the procedure. The nurse will give you more medication if needed. You will feel relaxed, but you will be awake so that you can follow instructions.
  3. The area where the doctor will be working will be cleaned and shaved.  You will be covered with sterile drapes from your shoulders to your feet.
  4. The doctor will insert small catheters into your fistula and may inject blood thinners.
  5. The doctor will inject the dye. The technologists working with your doctor will take X-ray pictures.

After the procedure:

  1. You will go to the recovery room, where the nurse will check you blood pressure, heart rate, and fistula.
  2. When the blood thinners have worn off, the catheters will be removed.  The nurse will apply pressure to the site to prevent bleeding.
  3. If you are an outpatient, you may leave after a short recovery period.  You will need someone to drive you home.
  4. Procedure and recovery times vary greatly from patient to patient.  The time needed depends on how big and where the blockage is in the fistula, and how long it takes for the blood thinners to wear off.  You may be at the hospital most of the day.

After you go home:

  • You may drive after 24 hours.
  • You may resume normal activities the next day.
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