cava. This blockage
severe face and
Same patient as
vena cava. Face
|Venous Intervention and Dialysis Access
For patients with kidney failure, dialysis
is a matter of life-and-death. Hemodialysis is the best method for clearing
the toxins from the blood. To accomplish this, a large volume of blood
must be removed from the body, run through the dialysis machine, and returned
to the body.
This is best accomplished by using a surgically
created fistula or shunt between the arteries and veins, which results
in a high rate of flow through the shunt, as is needed for dialysis. While
these shunts are vital for successful dialysis, they are often difficult
to keep open.
This difficulty is related to the body’s
response to this high flow state in the veins. In response to this flow,
a process of scar tissue formation occurs (intimal hyperplasia) that closes
these veins, causing the grafts or fistulas to function poorly or to even
Interventional radiologists play an important
role, in conjunction with the surgeons who place these shunts and the nephrologists
who perform the dialysis, in managing these shunts and the integrity of
the veins on which a dialysis patient is dependent.
Following is a description of some procedures
RCT physicians perform to preserve the function of a dialysis graft or
fistula, which is of vital importance to the dialysis patient.