Venous angiography of subcutaneous hemodialysis fistulas.

Venous angiography was performed on 256 subcutaneous arteriovenous dialysis fistulas. The technique involves temporary arterial inflow occlusion, needle injection of contrast material into the venous segment, and rapid sequence roentgenograms as arterial flow is restored. It requires no fluoroscopy or catheterization, avoids trauma to either the brachial or axillary arteries, and can be performed on an outpatient basis. Indications for fistulography included technical complications during dialysis, high-output cardiac failure, aneurysms, sepsis, and other reasons. Studies demonstrated significant stenosis or occlusion, insignificant stenosis, malpositioned needles, excessive fistula flow, aneurysms, thrombus formation, maturation failure, and other and normal findings. Only one study caused fistula thrombosis. Ninety-one percent of the studies provided information useful in the overall clinical management of the patients.