Fistulogram in Queens, NY – Dialysis Fistula Maintenance

Fistulogram in Queens at Medex Diagnostic & Treatment Center. At Medex Diagnostic & Treatment Center in Forest Hills, Queens, our board-certified interventional radiologists provide same-day fistulograms and minimally invasive repairs. We work closely with dialysis units in Rego Park, Kew Gardens, Glendale, Jamaica, and across Queens so patients stay on schedule and out of the hospital.

Over 800,000 Americans live with end-stage kidney disease (ESKD) and rely on hemodialysis to stay alive. In New York City, thousands of patients visit dialysis centers several times a week. To make dialysis work, most use a special arm connection called an arteriovenous (AV) fistula that lets blood flow to and from the machine.

Keeping that fistula open is critical. If it narrows or clots, treatments can be missed and emergency hospital visits may follow. A quick imaging test called a fistulogram finds trouble early, clears blockages, and helps avoid more surgery.

Fistulogram Overview

A fistulogram (sometimes called a dialysis fistulagram) is a targeted X-ray study in which contrast dye is injected directly into the fistula under fluoroscopy. The dye outlines the entire circuit—from artery to vein to central chest veins—revealing narrow segments, kinks, and clots in real time. Unlike ultrasound surveillance, a fistulogram lets the interventional radiologist treat detected problems on the spot with angioplasty or mechanical thrombectomy, often restoring full flow in a single outpatient visit.

Medex’s angiography suite on Queens Boulevard is equipped with low-dose digital subtraction technology; most procedures take less than 45 minutes and are done with light IV sedation—no hospital admission, no general anesthesia.

What is an AV fistula?

An AV fistula is a surgically created connection between one of the forearm or upper-arm arteries and a nearby vein. The high-pressure arterial flow enlarges and toughens the vein so that large-bore dialysis needles can be placed repeatedly without collapse. Compared with synthetic grafts or catheters, fistulas last longer, carry the lowest infection risk, and allow higher blood-flow rates—translating to more efficient toxin removal during dialysis. ncbi.nlm.nih.gov

Why meticulous fistula maintenance matters

Once matured, the fistula becomes the patient’s “lifeline.” Just like coronary arteries, however, fistulas can narrow (stenose) from scar tissue or clot off entirely. National Kidney Foundation guidelines emphasize careful daily inspection, keeping the site clean, avoiding tight clothing or blood-pressure cuffs on the access arm, and notifying clinicians immediately if the vibration (“thrill”) weakens. Even with perfect self-care, the constant high-flow environment can trigger silent scarring that only shows up on routine surveillance imaging. kidney.org

Warning signs your fistula is in trouble

Patients, dialysis nurses, or technicians may notice:

• Rising venous pressures on the dialysis machine
• Prolonged bleeding after needle removal
• Arm or hand swelling, new pain, or skin discoloration
• A faint or absent thrill when you place fingers over the access

Any of these red flags signals possible stenosis or clot and should prompt an urgent fistulogram referral.

When your nephrologist orders a fistulogram

• Declining dialysis adequacy—your Kt/V numbers drop despite good adherence
• Machine alarms for high arterial or venous pressures
• Palpable stenosis found on routine physical assessment
• Pre-transplant evaluation to certify access patency in case dialysis is still needed after surgery
• Annual surveillance for high-risk grafts or long-standing fistulas

Step-by-step: your day at Medex

1. Check-in & consent. Front-desk staff verify insurance, medications, and contrast-allergy history.
2. IV line & monitoring. A nurse places a small IV in the non-access arm for mild sedative and hydration.
3. Local anesthesia. After sterile prep, the radiologist inserts a tiny sheath into the fistula, similar to dialysis cannulation.
4. Contrast run. Contrast is gently hand-injected while continuous X-ray captures a movie of blood flow.
5. On-the-spot repair. If a narrowing is found, a balloon catheter is passed and inflated to widen the segment; clots are suctioned or macerated.
6. Closure & recovery. The sheath is removed, and a pressure bandage is applied. After 30–60 minutes of observation, most patients return home on the subway or via a family ride.

Patients typically resume dialysis at their next scheduled session—often the same day.

Safety profile and possible complications

Fistulograms are extremely safe, but any invasive procedure carries small risks: bruising, contrast allergy, vessel spasm, or, rarely, perforation. Medex mitigates these with ultrasound-guided access, the latest non-iodinated contrast options for patients with iodine sensitivity, and immediate vascular-surgery backup at nearby tertiary centers if needed. Overall complication rates remain under 1 %, and most issues are minor and treatable on site.

Care after your fistulogram

Queens nephrologists usually prescribe low-dose aspirin, caution against heavy lifting for 24 hours, and arrange a re-check of access pressures at your next dialysis session. Long-term, the same golden rules apply: daily thrill checks, clean skin, rotate needle sites, and attend all scheduled surveillance visits. Adherence can double the lifespan of a fistula compared with reactive care alone.

Why Queens patients choose Medex Diagnostic & Treatment Center

• All-in-one vascular imaging hub. Duplex ultrasound, fistulograms, and central-vein angioplasty in one location mean fewer outside referrals.
• Transit-friendly. Medex sits beside the 71 Av/E F M R subway stop and offers a street-level entrance for mobility-assistance vehicles.
• Multilingual staff. English, Russian, Spanish, and Mandarin spoken—critical in the borough’s diverse dialysis population.
• Insurance alignment. In-network with Medicare, Medicaid, Healthfirst, Emblem, and most commercial plans.
• Same-week scheduling. Reserved slots for time-sensitive access salvage minimize catheter days and infection risk.
• Integrated chronic-care model. On-site cardiology, endocrinology, podiatry, and wound care help manage the comorbidities that threaten fistula health. medexdtc.com

Medex radiologists send immediate post-procedure images and reports to your nephrologist via secure portal, advise on needle-site rotation, and set reminders for three- or six-month follow-up imaging depending on stenosis severity. This continuum allows local dialysis teams to focus on ultrafiltration targets while Medex guards the access.

Frequently asked questions

Is the procedure painful?
Only local lidocaine is necessary; most people feel nothing more than pressure. Minimal twilight sedation keeps you relaxed, and you can speak with the team throughout.

Can I eat before my appointment?
Avoid solid food for six hours; clear liquids up to two hours are fine. Controlling stomach contents reduces the small risk of aspiration under sedation. uvahealth.com

Will my dialysis schedule change?
Usually not. Many Queens patients go straight from Medex to their afternoon dialysis seat—your access will be ready.

What if I’m allergic to contrast dye?
Medex uses low-osmolality agents and can pre-medicate with steroids/antihistamines or switch to carbon-dioxide angiography for severe allergies.

How often will I need a fistulogram?
Stable fistulas may go years without imaging; high-flow grafts or previously stenosed fistulas often require annual checks. Your nephrologist determines timing based on machine pressures and blood-work trends.

Does insurance cover fistulograms?
Yes. Medicare covers diagnostic fistulograms and therapeutic angioplasty as medically necessary. Medex pre-authorizes commercial plans so you know any co-pay upfront.

Is there radiation exposure?
Dose is low—comparable to a few plain X-rays—and far outweighed by the benefit of salvaging your access. Lead shielding protects other body parts.

Can I drive myself home?
Because of mild sedation, arrange a friend, family member, or rideshare. The Forest Hills–71 Av station is one block away if you prefer public transport the next morning.

What if the fistulogram shows nothing?
A normal study reassures your dialysis team and can rule out access as the cause of rising machine pressures, guiding further work-up.

How do I book?
Call (718) 275-8900 or use the Medex patient portal to request an “AV-Fistula Evaluation.” Same-week slots are held for Queens referrals.