- SIR GANGA RAM HOSPITAL, Old Rajinder Nagar, Rajinder Nagar, Delhi, 110060
- Mon - Sat : 9:00 AM - 6:00 PM
Gallery Posts
An arteriovenous (AV) graft provides access to the bloodstream for people undergoing hemodialysis. When a graft develops narrowing, blood clots, or reduced blood flow, dialysis can become difficult or the access may stop working.Dr. Anadi Gupta, MD, FVIR, EBIR, Consultant at Sir Ganga Ram Hospital, provides evaluation and endovascular treatment options for dialysis access complications, including AV graft angioplasty, thrombectomy, and stenting when appropriate.
Consultant, Sir Ganga Ram Hospital
An arteriovenous graft is a type of vascular access used for hemodialysis. It connects an artery to a vein using a specially designed synthetic tube, usually placed under the skin of the arm. The graft allows repeated needle access so blood can travel to and from the dialysis machine.Over time, an AV graft may develop narrowing, commonly near the vein connection, or become blocked by a blood clot. These complications can reduce blood flow, increase pressure within the access, and interfere with effective dialysis.
Changes in your dialysis access can indicate a problem.Seek medical evaluation if you notice reduced vibration,difficulty during dialysis, prolonged bleeding, arm swelling or if the graft suddenly stops working.
AV graft repair includes procedures designed to restore blood flow through a narrowed or blocked dialysis graft. The treatment is selected according to the location and severity of the problem.
Balloon angioplasty is used to widen a narrowed section of the graft or its draining vein. A catheter is guided to the affected area, and a small balloon is inflated under imaging guidance to improve blood flow.
If a blood clot blocks the graft, thrombectomy may be performed to remove the clot and restore circulation. Depending on the situation, mechanical clot-removal devices, aspiration techniques, or other methods may be used.
A stent may be considered when additional support is needed for selected narrowings or when a lesion is difficult to manage with angioplasty alone. Stenting is not necessary in every case and must be planned with consideration for future dialysis access options.
Sometimes, the problem is not limited to the graft itself. Narrowing in the draining veins or central veins can contribute to swelling, increased pressure, and access dysfunction. Additional imaging and treatment may be needed to address the underlying cause.
A vascular and endovascular specialist may evaluate patients who have:
Dr. Anadi Gupta reviews the patient's dialysis history, symptoms, previous access procedures, and any recent problems during dialysis.
A clinical examination and Doppler ultrasound may be used to assess blood flow and identify narrowing or clot formation. Fistulography or other imaging may be required to evaluate the access circuit in more detail.
The specialist determines whether angioplasty, thrombectomy, stenting, surgical revision, or another approach is most appropriate.
A catheter is introduced through a suitable access point. Balloon angioplasty is performed for narrowing, while an appropriate thrombectomy technique may be used when a clot is present. A stent may be placed in selected cases.
The team evaluates blood flow through the graft and checks for immediate complications. The access is assessed to determine whether it is suitable for dialysis use.
Follow-up helps assess graft function and identify recurrent narrowing or clotting. The treating team will advise when the graft can be used for dialysis and whether additional monitoring is required.
Dr. Anadi Gupta, MD, FVIR, EBIR, is a Consultant at Sir Ganga Ram Hospital with a focus on vascular and endovascular interventions.His areas of practice include AV graft repair through angioplasty, thrombectomy, and stenting when appropriate, as well as AV fistula repair, central venous angioplasty and stenting, DVT thrombectomy, peripheral arterial interventions, and IVC filter insertion and retrieval.
Get your dialysis access assessed and explore suitable treatment options with Dr. Anadi Gupta, Consultant at Sir Ganga Ram Hospital.
Many narrowed or blocked grafts can be assessed for treatment using angioplasty, thrombectomy, or another suitable procedure. The likelihood of success depends on the cause, duration, and severity of the blockage.
An AV fistula connects an artery directly to a vein. An AV graft uses a specially designed tube to connect an artery and a vein. Both can provide access for hemodialysis.
Angioplasty is generally a minimally invasive, catheter-based procedure performed under imaging guidance. Some complications may require surgical revision or another treatment approach.
Not always. Balloon angioplasty alone may be sufficient for some narrowings. A stent is considered in selected situations after evaluating the lesion and future access needs.
Yes. Recurrent narrowing and clot formation can occur. Monitoring and timely evaluation of new dialysis access problems are important.
The timing depends on the procedure and the condition of the graft. Your treating specialist and dialysis team will confirm when it is safe to use the access.
If the usual vibration disappears or the graft suddenly stops functioning, contact your dialysis team and seek urgent medical assessment. Do not wait for your next routine dialysis session.