I saw my vascular surgeon today. He ran the sonogram machine over my arm a few times, to look at it. It looks very much like the sonogram machines that you see on ER when they are checking a pregnancy, except that in my arm, there is only blood, no babies. The doctor said that he would have to schedule an appointment for me with radiology to have an Intervention exam.
I did not get a lot of information from him about this exam, so I looked it up on the Internet. The University of Virginia called the exam a Fistulagram, and had the following to say:
A fistulagram is an x-ray study of your fistulas and this procedure can detect problems such as a clot or narrowing. Early detection and treatment can improve your fistula’s performance and limit future complications.
They describe the procedure as follows:
The Interventional Radiologist will insert a needle into our fistula, very similar when accessing your graft for hemodialysis you will feel warm in your hand, arm, and chest, and may get a metallic taste in your mouth. These sensations only last 10-15 seconds. Several x-ray pictures are needed to complete the test. These pictures are reviewed by the Interventional Radiologist and, if necessary, the findings discussed with your referring doctor. If there is an area of narrowing or clot present in the blood vessel that can be helped by balloon angioplasty, stint, clot dissolving medications, or a clot breaking device, this may be done at this time. A fistulagram usually takes 2-3 hours to complete.
I will be having this procedure on Wednesday, November 2. I have to be at the hospital at 7am and will have to procure a ride home (so don’t be surprised if I call you this week). The procedure does not sound like it will be difficult or that there should be many problems. Hopefully, they will be able to find out why my access flow is less than 400, and maybe they will have a solution that is non-surgical. If they cannot fix the problem, it will give the surgeon a good idea of where to go if I need a surgical solution. He said that possible surgical solutions might include disconnecting a small vein from the fistula in case it is decreasing the available pressure.
Thanks for coming by to read. I hope that this was informative. If not, please let me know.
460) Annual Update
4 years ago
3 comments:
Nathan,
Hi! This is Barbara from Columbus Ohio. When we schedule our patients for fistula grams we set them up @ intervational radiology. We always recommend using the surgeon that put our patients fistula in so you made a good choice in staying with your doc. If you do need sugery they should be able to fix it then.
Take care Barbara Wood
Thanks. That is about what I gathered from the surgeon when I spoke with him Thursday. I'll probably ask several questions when I go in for the procedure, but that's what I like to do. I love being an informed patient.
Nathan- call me if you need a ride.
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