What are warning signs of access dysfunction?
Poor dialysis flow, prolonged bleeding after needle removal, high venous pressures, arm swelling, a weak thrill or sudden loss of thrill should prompt evaluation.
How can a failing fistula be treated?
Angiography can identify the narrowing. Balloon angioplasty is commonly used for stenosis, and selected thrombosed accesses may be salvaged with catheter-based thrombectomy techniques.
Why timing matters
A newly thrombosed access may be easier to salvage when treated promptly, although success depends on anatomy, clot burden and the underlying lesion.
Preserving future access
Treatment aims not only to restore current dialysis but also to preserve future vascular access options.
Central venous stenosis with severe arm swelling
Clinical and venographic images demonstrating central venous outflow obstruction and improvement after endovascular treatment.
Frequently asked questions
Can a thrombosed fistula be reopened?
Sometimes. The likelihood of salvage depends on the age of the fistula, clot burden, location of stenosis and time since thrombosis.
Does every stenosis need treatment?
No. Treatment is usually considered when a stenosis is clinically significant and affecting dialysis function.