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Vascular Access for Dialysis Procedures

Fistula Occlusion or Stenosis: Surgical and Endovascular Treatments (Balloon/Stent)

Fistula occlusion or stenosis is one of the most common complications that interfere with dialysis efficacy in hemodialysis patients.

Procedure Duration :

60 - 90 min

What is Fistula Occlusion and Stenosis?

Stenosis (narrowing) that develops in an AV fistula gradually reduces blood flow, while occlusion (thrombosis) can cause the fistula to become suddenly unusable. These issues most commonly occur at the anastomosis site or the needle insertion areas.

Endovascular Treatments

Balloon Angioplasty

The narrowed segment of the fistula is expanded using a balloon catheter.

  • It is the first-line treatment.
  • Performed under local anesthesia.
  • Allows the possibility of dialysis on the same day.

Stent Placement

Performed in cases of recurring or elastic stenosis despite balloon angioplasty.

  • Aims to make the vessel patency permanent.
  • Preferred in selected cases.
  • Creation of a new anastomosis.
  • Removal of the occluded segment.
  • If necessary, planning of a new AV fistula.

Surgical methods are preferred when endovascular treatments are insufficient or not suitable for the condition.

Before treatment, Doppler Ultrasound and, if necessary, angiographic evaluation are performed. The goal is to make the fistula usable again as quickly as possible.

  • Insufficient blood flow during dialysis
  • Difficulty with needle insertion
  • Decreased or absent bruit (whooshing sound) in the fistula
  • Swelling in the arm or hand
  • Prolonged dialysis time
  • Preservation of the existing fistula
  • No interruption in the dialysis process
  • Reduced need for creating a new vascular access
  • Lower risk of infection and complications
  • Early evaluation of fistula function
  • Regular Doppler ultrasound check-ups
  • Patient education and fistula care

All hemodialysis patients with detected flow issues in their AV fistula should be evaluated for these treatments. Early intervention significantly extends the lifespan of the fistula.

Frequently Asked Questions

You can explore the most commonly asked questions regarding our healthcare services and treatment methods.

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