Fistula thrombectomy is a procedure to remove a blood clot from a blocked dialysis fistula or graft.
Fistula angioplasty is a procedure to widen a narrow part of the fistula using a small balloon.
These procedures:
- Restore blood flow in the fistula
- Save your existing dialysis access
- Avoid the need for new surgery
- Allow dialysis to restart quickly
When a fistula or graft fails and cannot be salvaged immediately, dialysis still needs to continue without interruption. In such situations, a tunnelled hemodialysis catheter (Permcath) is placed as a temporary or long-term alternative — a soft tube inserted into a central vein in the neck or chest that allows dialysis to carry on safely while the fistula is being repaired or a new access point is being planned.
A fistula that keeps failing despite repeated interventions may have a deeper problem upstream. Central vein blockage, where the large veins draining into the heart become narrowed or obstructed, is one of the most overlooked causes of recurrent fistula dysfunction. Even a well-functioning fistula will fail repeatedly if the central vein it drains into remains blocked, making assessment and treatment of central veins an essential part of dialysis access care.
Beyond dialysis-specific access, patients on long-term medical treatment often need reliable venous access for other purposes such as chemotherapy, antibiotics, or nutrition. A PICC line , a thin catheter inserted through an arm vein and advanced into a central vein, serves this purpose safely and can be maintained for weeks to months, sitting within the same vascular access family of minimally invasive solutions that fistula repair belongs to.