Dialysis fistula angioplasty

An arteriovenous fistula is a surgically created connection between an artery and a vein in the arm, used for haemodialysis. Over time, the vein can narrow (stenosis): flow drops, dialysis becomes less effective and the fistula may block. Angioplasty widens the narrowing with a balloon introduced into the fistula. The procedure is performed in the catheterisation laboratory under local anaesthesia, through a direct puncture of the fistula or the arm artery. The doctor visualises the fistula with an injection of contrast dye, then inflates a balloon at the narrowing. A stent or drug-coated balloon may be used in some cases. If the fistula is blocked, the clot can often be removed in the same session. Angioplasty allows the same fistula to be used for longer and avoids a dialysis catheter or further surgery. It is often requested by the dialysis team when they notice a change in the fistula. At Clinique Pasteur Tunis, the procedure is performed in a latest-generation catheterisation laboratory and scheduled so as not to disrupt dialysis sessions.