Drop off only

Bus Stop

Carpark

Taxi Stand / Drop off

Kent Ridge MRT Station @ Level 1

A

Linkway @ Level 1Via MRT station(Exit A)

B

Linkway @ Level 1

C

Linkway @ Level 4

Your vital signs will be monitored and pressure will be applied tothe insertion site where the catheter is inserted to stop bleeding.After observation, you will be discharged if deemed well.

• Avoid heavy lifting of more than 5kg and refrain from physical exertions like heavy housework on the affected limb.

• Take your medication as prescribed (especially aspirin or clopidogrel).

• If the insertion site becomes increasingly painful, warm to touch, swollen, red, or shows signs of bleeding, bruising or increase in size, seek medical help immediately or go to the nearest A&E.

What to expect after the procedure?

What are the risks and benefits?

Frequently Asked Questions:

National University Hospital5 Lower Kent Ridge Road, Singapore 119074Tel: 6779 5555 Fax: 6779 5678 Website: www.nuh.com.sg

Contact InformationNational University Heart Centre, Singapore1 Main Building of NUH, Diagnostic Vascular Laboratory, Level 3.Opening Hours: 8.30 am - 5.30 pm (Monday - Friday)Closed on Weekend & Public HolidaysWebsite: www.nuhcs.com.sg

Getting to NUHCircle Line Kent Ridge MRT StationCommuters can transit at the Buona Vista MRT Interchange and alight two stops after at the Kent Ridge Station. The station is served by three exit-entry points.Exit A: Right at the doorstep of National University Heart Centre, Singapore.Exit B: Along South Buona Vista Road, which links to Singapore Science Park 1.Exit C: Leads to NUH Medical Centre.

Information in this brochure is given as a guide only and does not replace medical advice from your doctor. Please seek the advice of your doctor if you have any questions related to the surgery, your health or medical condition. Information is correct at time of printing (May 2015) and subject to revision without notice. Copyright© is held by the publisher. All rights reserved. Reproduction in whole or in parts without permission is strictly not allowed.

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STEP

02

Vascular Access Intervention

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Having a �stulogram, and if needed, a �stuloplasty, can help toprevent problems with your dialysis and prolong the life of yourfistula. Risks of bruising, pain, and very rarely, acute failure of thevascular access may occur.

1. How long is the procedure?It is an estimated 30 to 90 minutes depending on the locationand the complexity of the narrowing(s) or blockage(s).

2. Can I still use my fistula or graft after procedure?Patients who have undergone the procedure are usually ableto use their �stula or graft for their dialysis the next day.

3. Will I need to go through this procedure again?Every year, 30% of the patients will require the procedureagain to prolong the longevity of the �stula or graft.

4. What happens if I choose not to go for this procedure?Your �stula or graft will eventually fail and will be unable todo dialysis.

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ENGLISHAvailable in :

What is Vascular Access Intervention?

What is a Fistulogram?

What to expect during the procedure?What is a Fistuloplasty?

What to expect before the procedure?

A vascular access intervetion is a procedure of gaining access to apatient’s blood for hemodialysis, either in the form of an Arteriovenous Fistula (AVF) or Arteriovenous Graft (AVG). Blood is drawn and returned to your body by the dialysis machine via the vascular access.

A �stulogram is a procedure done by an interventionist usingan X-ray to locate the area where the blood vessels are narrowedor blocked.

It is required when a person has repeated dialysis and the lining of the blood vessel(s) has overgrown and narrowed to the point that dialysis becomes dif�cult. Over a period of time, blood clots and blockages may also form.

Narrowing of theblood vessel

A �stuloplasty is done by inserting a balloon-tipped, small plastictube into the narrowed vessel(s) and then inflating it, forcing it toopen up the narrowing so that more blood can flow through. After the procedure, the catheter and balloon will be taken out.

You will be in an operating theatre or clean procedure room. You will be positioned lying down on the X-ray bed.

Your heart rate, blood pressure and oxygen level will be monitoredthrough a blood pressure cuff on your arm or calf. A clip on your�nger ensures you have enough oxygen throughout the procedure.

The interventionist will give you medication to relieve pain/discomfort and maybe sedatives, which will help to relax you before the procedure.

However, you will be kept awake in order to follow instructions the interventionist may have.

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The interventionist will place temporary 'small tubes' known ascatheters, either at your groin area or directly into your �stula. Adye will then be injected through the catheter so that the targetedvessel(s) can be seen through the X-ray. The technologists workingwith your interventionist will take X-ray pictures.

If narrowing is found, interventionist will do a 'balloon' a.k.a.fistuloplasty right away after the fistulogram. This is rathercommon.

You may feel a stinging sensation when the local anaesthetic isapplied, and when the balloon is inflated.

The area where the interventionist will be working on will be cleaned and you will be dressed in sterile drapes from your shoulders to your feet.