Nephrology (Kidney) Procedures

This video outlines kidney procedures offered by Dayton Interventional Radiology in Ohio.

• Arteriovenous Fistulas for Dialysis: creation of arteriovenous (AV) fistulas to strengthen and widen veins to aid in long-term dialysis.
• Dialysis Catheter Placements: installation of a hemodialysis catheter into the jugular vein to allow dialysis without the wear and tear on veins.
• Renal Biopsy: removal of a small amount of renal tissue for examination.
• Renal Cyst Drainage: removal of fluid from a cyst in the kidney.
• Renal Artery Stenting: placement of a mesh tube (stent) to open and support a renal artery that has collapsed or been narrowed by plaque buildup.
• Thrombectomy: removal of blood clots in the renal artery.

An arteriovenous fistula (AV fistula) is a linkage or short circuit between an artery and a vein in which the blood from the artery loops back directly into the vein. When these AV fistulas occur congenitally or due to injury, they can cause problems and require treatment to prevent heart failure. Naturally occurring AV fistulas may be diagnosed by angiography and can be repaired by inserting plugs or coils into the linkage.

When kidney dialysis is needed frequently, such as in late stage renal failure, the vein must be pierced for each treatment. Over time, the vein may becomes inflamed and scarred, and the chance of blood clots increases as the vessel narrows. To prevent this, our doctors can deliberately create an AV fistula in your arm. This small medically induced AV fistula does not have the risks that a naturally occurring AV fistula has, and will widen and strengthen the vein, making needle insertion easier and reduce the chance of blood clots.

Arteriovenous fistulas may be evaluated with AV fistulagrams, in which an x-ray contrast medium is placed in the AV fistula so that the blood flow may be viewed on a monitor to evaluate the health of the fistula.

If your medically-created AV fistula has narrowed or become occluded, our doctors can repair and widen it using AV angioplasty, in which the connection between the artery and the vein is widened using a balloon catheter.

AV fistula creation is a catheter-based procedure that our doctors perform at Good Samaritan Hospital in Dayton, Ohio. The procedure takes about an hour and a short hospital stay is expected.

AV fistulagram and AV angioplasty are catheter-based procedures that our doctors perform at our freestanding facility. These procedures take about an hour and no overnight stay is required.

When kidneys fail, the body loses its ability to keep the blood clean. The function of the kidneys can be replaced by hemodialysis, in which the blood is removed from the body, filtered to remove impurities, then returned to the body. This procedure can maintain healthy blood, but it causes wear and tear on the veins that are frequently pierced to remove and return the blood.

A hemodialysis catheter can be placed directly into the large vein at the base of the neck (jugular vein), allowing the blood to be filtered without weakening the veins. Traditionally, these catheters have been implanted surgically, but our doctors can use a minimally invasive procedure to place the catheter, reducing complications and risks.

If the jugular vein is unavailable for any reason, our doctors can also provide translumbar catheter placement.

Hemodialysis catheters are often placed only as a temporary measure because they are prone to infection and blood clots over a long period of time. An arteriovenous fistula is a stronger and more resilient solution, but it takes several months while to form a secure enough connection. A catheter is a good way to bridge the gap until the AV fistula is ready.

Hemodialysis catheter placement is a procedure that our doctors perform at Good Samaritan Hospital in Dayton, Ohio. The procedure takes one or two hours and requires a short hospital stay.

A renal biopsy is done to remove a small amount of kidney tissue for laboratory examination to aid in diagnosis.

Our doctors use fluoroscopy (live X-ray) to guide the needle to the precise location, so the biopsy is quick and accurate.

Renal biopsy is a needle-based procedure that our doctors perform at our freestanding facility. The procedure takes about 30 minutes and does not require an overnight stay.

Renal artery stenting is a procedure to treat renal artery stenosis, the narrowing of the renal artery due to atherosclerosis (plaque build up) or fibromuscular dysplasia. The narrowed artery is unable to carry blood effectively and can result in hypertension or acute renal failure. A balloon angioplasty can be used to open the narrowed artery, and a mesh stent can be placed to hold the artery open.

Renal artery stenting is a catheter-based procedure that our doctors perform at Good Samaritan Hospital in Dayton, Ohio. The procedure takes about an hour and a short hospital stay is expected.

Renal cysts, small sacs filled with fluid, can form in the kidneys as people grow older. These cysts are nearly always benign, and may not cause any symptoms or problems. If your doctor notices a cyst when doing a ultrasound, CT (computer tomography) scan, or MRI (magnetic resonance imaging) scan, but you haven’t noticed any pain, fever, frequently urination, or blood in your urine, nothing needs to be done. A follow-up scan every year will be sufficient to watch for changes.

If the cyst causes pain or other problems, our doctors can perform renal cyst drainage or aspiration, in which a thin needle is inserted into the cyst using fluoroscopic (live X-ray) guidance to precisely locate the cyst. Then the clear fluid is drawn out of the cyst. Sometimes, it may also be necessary to inject a sclerosing material to destroy the cyst so it will not refill.

Renal cyst drainage is a needle-based procedure that our doctors perform at our freestanding facility. The procedure takes about 30 minutes and no overnight stay is required.

Thrombectomy and thrombolysis are used to treat blood clots within arteries or veins. These can occur for many reasons, including deep vein thrombosis (DVT) and peripheral artery disease (PAD). Thrombectomy is the removal of the blood clot, thrombolysis is the destruction of the blood clot.

A flexible catheter is inserted and guided to the location of the clot with the help of fluoroscopy (live X-ray). In thrombolysis, a clot-busting (thrombolytic) chemical is injected directly into the clot so that it dissolves harmlessly. In thrombectomy, the clot is grabbed and then slowly drawn out of the vein or artery.

These are both catheter-guided procedures that our doctors perform at our freestanding facility. The procedure takes about an hour and no overnight stay is required.