Dialysis Access Maintenance
Interventional radiology plays a critical role in maintaining functional dialysis access and preventing interruptions in care.
Symptom Onset & Initial Evaluation
Access problems are often first noticed during dialysis sessions or routine monitoring. Patients are typically referred when they experience:
- Decreased dialysis flow rates or machine alarms
- Prolonged bleeding from the access site after dialysis
- Swelling of the arm or hand containing the access
- Sudden loss of thrill or bruit, suggesting clotting
At The Medical Group of New Jersey, providers work closely with dialysis centers and nephrologists to identify access issues early, often before complete failure occurs.
Diagnosis
Evaluation focuses on identifying the cause of access dysfunction and typically includes:
- Careful physical examination of the fistula or graft
- Ultrasound or fistulogram imaging to assess blood flow, narrowing, or clot formation
These studies help determine the most effective intervention while preserving future access options.
Treatment Guidance & Management
Interventional procedures are designed to restore function quickly and may include:
- Balloon angioplasty to open areas of narrowing
- Mechanical thrombectomy to remove clots
- Stent placement when recurrent narrowing or structural issues are present
Most procedures are performed on an outpatient basis, allowing patients to resume dialysis promptly.
Ongoing Management & Monitoring
Long-term care at The Medical Group of New Jersey emphasizes access preservation and coordination of care through:
- Routine surveillance to detect early dysfunction
- Strategies to reduce dependence on temporary dialysis catheters
- Ongoing collaboration with the nephrology and dialysis teams
This proactive approach helps extend the lifespan of dialysis access and supports uninterrupted kidney replacement therapy.