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Lahey Health is now part of Beth Israel Lahey Health

by EBSCO Medical Review Board
(Sinogram)

Definition

A fistulogram is a special x-ray of a pathway that is used during kidney dialysis. The pathway is called a fistula.

Reasons for Procedure

A fistulogram is done to look for things that may be causing problems with blood flow. It can show clots and narrowing.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Allergic reaction to the contrast material
  • Infection

Things that may raise the risk of problems are:

  • Smoking
  • Chronic diseases, such as diabetes or obesity

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Types of anesthesia that may be used
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
  • Fasting before the procedure, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from the procedure

A contrast dye may be used. It will highlight the area on the x-rays. The team will need to know about any problems you have had with contrast dye.

Anesthesia

You may be given:

  • A sedative to help you relax
  • A local anesthetic to numb the area

Description of the Procedure

The doctor may give medicine to help you relax or numb the area.

A thin tube will be passed into the fistula. The contrast dye will be sent through the tube. You may feel a warm sensation when it is given. Images will be taken. Other tools may be set down the tube to take measurements or treat the problems. The tube will be removed when all image and work are done. Pressure will be placed on the site to stop any bleeding. One or two stitches may be needed.

How Long Will It Take?

About 30 minutes

Will It Hurt?

You may feel some pressure when the tube is placed. The dye may also make you feel uncomfortable for a short time.

Pain, swelling, and bruising in the area are common after the procedure. This will go away in a few days.

Average Hospital Stay

You may go home the same day. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Care Center

The staff may:

  • Give you pain medicine
  • Check your fistula for any bleeding

During your stay, staff will take steps to lower your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks

You can also lower your chance of infection by:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
At Home

Some activity will need to be limited for 24 hours.

Call Your Doctor

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, excessive bleeding, or discharge
  • Problems feeling your pulse at the fistula site or your pulse feels weak

If you think you have an emergency, call for medical help right away.

RESOURCES

Family Doctor—American Academy of Family Physicians  https://www.familydoctor.org 

RadiologyInfo.org—Radiological Society of North America, Inc.  https://www.radiologyinfo.org 

CANADIAN RESOURCES

Canadian Association of Radiologists  https://www.car.ca 

Health Canada  https://www.canada.ca 

References

Angiogram/fistulogram and angioplasty of your AV fistula or graft. MyHealth.Alberta.ca Network website. Available at: https://myhealth.alberta.ca/Alberta/Pages/angiogram-fistulogram-and-plasty-of-av-fistula-or-graft.aspx . Accessed June 5, 2020.

Fistulagram. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/interventional-radiology/procedures/fistulagram/ . Accessed June 5, 2020.

Fistulogram. UAB Medicine website. Available at: https://www.uabmedicine.org/patient-care/treatments/fistulogram. Accessed June 5, 2020.

Fistulogram/sinogram. RadiologyInfo.org—Radiological Society of Family Physicians website. Available at: https://www.radiologyinfo.org/en/info.cfm?pg=fistulogram-sinogram#benefits-risks. Accessed June 5, 2020.

Vascular access for hemodialysis. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/vascular-access-for-hemodialysis. Accessed June 5, 2020.

What to expect when having a fistulogram. UHN website. Available at: https://www.uhn.ca/PatientsFamilies/Health%5FInformation/Health%5FTopics/Documents/Fistulogram.pdf . Accessed June 5, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
  • Review Date: 07/2021
  • Update Date: 09/29/2021