Dialysis Intervention

Dialysis intervention is an interventional radiology procedure that is used to fix a blocked or narrowed venous or arterial access point for dialysis.

If your child has acute kidney injury or chronic kidney disease, he or she may require dialysis to help clean the blood. If the access point for dialysis is not working well due to a blood clot, narrowed vein or other issues, he or she may require a dialysis intervention.

There are several ways the interventional radiologist can perform a dialysis intervention, including:

Angioplasty. During this procedure, a tiny balloon is used to expand the vein. This opens the vein wider to allow better flow during dialysis.
Stent. A stent is the insertion of a metal or plastic tube that expands the vein and remains in place. This opens the vein wider to allow better blood flow for dialysis.
Fistulagram. The interventional radiologist uses a special type of X-ray imaging called a fistulagram and a special device to remove blood clots. During a fistulagram, contrast dye is used, which helps the doctor see blood flow and find the blood clots.

A dialysis intervention normally takes about one to two hours, including any sedation your child may need.

What to Expect

Angioplasty, stent and fistulagram procedures are performed through a small incision made in the vein or dialysis graft in the arm that is just under the skin.

The process includes the following steps:

A portion of your child’s arm will be numbed, and he or she will be given a sedative and monitored closely by an anesthesiologist.
The interventional radiologist will make a small incision, expand the vein with angioplasty or a stent and remove blood clots if necessary.
Once the procedure is complete, your child will be taken to a recovery room for observation.

If your child’s procedure is an expansion of a vein in the arm, he or she will stay an hour or two and then go home. If it is time for dialysis, the dialysis technician can insert a catheter immediately and begin dialysis treatment.

Dialysis interventions carry some risks. Sometimes the incision may bleed, and in rare cases, infection is possible. There can be bleeding through the skin or under the skin. An allergic reaction to the dye used during the procedure is rare. Another rare occurrence is a blood clot forming and being carried by the blood into the lung (pulmonary embolism). These complications are rare. Your child's doctor strives to provide the safest care possible.

Key Points to Remember

Dialysis interventions improve the effectiveness of dialysis treatment for kidney disease.
Your child will be sedated during a dialysis intervention.
Your child will be able to go home the same day as the procedure and may receive dialysis that day if it is time for treatment.

Locations

In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.