When a Stent is Needed for a Dialysis Fistula in Albuquerque

Stent placement Albuquerque:

A stent may be needed if any of the following are present: narrowing, bleeding, or clotting at the fistula site, recurrent fistulas that do not heal after three months, or persistent symptoms such as pain or swelling. Stents can be placed in the dialysis facility and are most effective if they are placed within two weeks of the initial diagnosis of narrowing. The patient will then need to return to their dialysis center every month to have the stent checked to ensure it remains open and working properly.

How does a stent work?

A dialysis fistula can be monitored with Doppler and color-flow ultrasound to determine if a narrowing (stenosis) is developing or if a clot has formed. A physician may need to place the patient on heparin therapy, which is an anticoagulant until the stenosis can be opened up by inserting a stent into the narrowing.
The stents are inserted using either fluoroscopy, live x-ray imaging, or via CT scan guidance. The stents are thin metal tubes that are inserted through an artery and into the fistula. Once they are placed inside of the fistula, they create space within it so that blood can flow through it easier and maintain its integrity.

Determining the need for a stent:

If you have a dialysis fistula and are experiencing symptoms like swelling, pain, or a decrease in the flow through the fistula, contact our office. We will perform an ultrasound to assess the situation. If it is determined that you need a stent placement in Albuquerque, we will schedule you to come into our office. Once you are here, we will insert the tube of your stent and place it inside your fistula with fluoroscopy guidance. The whole process will take about an hour or two but this time frame may vary depending on how long it takes to get your stent inserted correctly.

Procedure for placing a stent:

The following steps are taken to place the stant:

•  The fistula is flushed with heparinized saline.
• A guidewire usually bent at a 90-degree angle and lubricated with heparinized saline, is inserted into the fistula lumen and advanced to its ostium.
• The wire can be left in place or removed as needed to facilitate the placement of the stant over it.
•  The guidewire may be cut off at any point after entering the arterial lumen and before reaching the ostium if the stant will be placed over it rather than inside of it (e.g., an angioplasty balloon).

Tips from our expert urologist:

Patients with dialysis fistulas have unique needs. The flow through the fistula must be maintained above a certain level to allow adequate hemodialysis. The fistulas can be monitored with Doppler and color-flow ultrasound to determine if a narrowing (stenosis) is developing or if a clot is forming. If the flow doesn’t meet requirements, you may need a stent placement in Albuquerque to maintain adequate drainage of the urine into the bladder. A stent should not be used unless other methods don’t work, such as medication or periodically clamping off the vein at night when there’s no fluid being pushed through it during sleep. These measures may be enough to fix your problem and make you avoid surgery if it’s not necessary.