When an individual experiences kidney failure, the body will have trouble cleaning one’s blood and maintaining the chemical balance within the body. Dialysis is a treatment option done to filter the blood when the body can no longer do this independently. There are two primary types of dialysis we perform at our outpatient facilities; hemodialysis and peritoneal dialysis.
Hemodialysis incorporates the use of an artificial kidney to remove blood from the body and clean it. After the blood is cleaned, it is pumped back into the body. To create blood flow into the artificial kidney, a vascular access point is created by the doctor, usually in the arm. Treatments last 3-5 hours and are done 3 times a week in-office. This is the most common type of dialysis treatment.
Peritoneal Dialysis requires a peritoneal dialysis catheter be surgically placed before the dialysis treatments start. The peritoneal dialysis catheter helps filter the blood through the lining of the abdomen, an area called the peritoneum. During this treatment, a dialysate is pumped into the peritoneum area. This dialysate fluid absorbs waste and toxins from the bloodstream and then the dialysate is removed from the body.
Dialysis treatments can be done with the following procedures:
A fistulogram uses fluoroscopy, a real-time x-ray using x-ray dye, that checks for any abnormalities within the blood flow that may interfere with other medical treatments. It produces images of any abnormal passage within the body called a fistula. Fistulas routinely have narrowings that reduce flow rates during dialysis. Fistulograms are necessary to detect any blockages that may interfere with dialysis treatments. These may lead the doctor to perform an angioplasty sometimes with a stent at the end. Many times, routine surveillance is needed for patients with recurring problems, which can be managed by Interventional Radiologists and Nephrologists.
Dialysis Catheter Placement
Dialysis is a medical treatment of exchanging and filtering blood for an individual when kidneys fail to function properly. A dialysis catheter is inserted by a radiologist into a major vein for the purpose of removing blood out of one side of the catheter, filtering it through a dialysis machine and pumping clean blood in through the other side. This can be either a temporary or a more permanent catheter.
An angioplasty is a procedure that uses x-ray guidance and a balloon catheter to open a blocked or narrowed blood vessel. By opening a blocked or narrowed blood vessel, blood flow will improve. A catheter will be inserted that will have a balloon over it which is inflated to open the blockage. Occasionally, these balloons will be coated with a chemotherapy agent, or drug-eluding balloons. Sometimes a stent may need to be placed if there is recoil of the blood vessel after the angioplasty.
Venous Stent Placement
A venous stent is a small, metal, mesh-like tube that is utilized when there is a blockage due to blood clots or damage to a vessel wall. Prior to a venous stent, an angioplasty is typically attempted. If there is failure of the angioplasty, the venous stent is placed. There are two types of venous stents; balloon-expandable or self-expanding. Some of these stents are bare-metal while others are covered.The appropriate type of stent will be chosen depending on the type of lesion. To insert the venous stent, the balloon placed during the angioplasty is removed and a catheter is inserted with a stent attached to the end. When the stent is placed in the appropriate location, it applies pressure to the walls of the vein to keep it open and allow for better blood flow.