Venoplasty

Index:

1. What is a venoplasty and how is it performed?

2. Why might one require a venoplasty?

3. What are the main risks involved?

4. What happens after a venoplasty?

5. What to watch out for following a venoplasty

6. Which specialist performs a venoplasty?

What is venoplasty and how is it performed?

A venoplasty is a minimally invasive procedure that uses a balloon to stretch out narrow central veins (typically in the chest or pelvis) using air pressure. The small balloon is inserted and hereafter inflated in order to stretch this narrowing. The balloon is then easily and quickly deflated and removed. During the procedure, the patient's skin (over the fistula) will be cleaned thoroughly followed by sterile drapes being placed in and around the area surrounding the fistula to allow for local anaesthetic to be injected. 

The next step in the routine procedure involves an extremely small tube then being inserted directly into the patient's fistula. The doctor performing the procedure is helped and guided by small guidewires, which are directly passed through this small inserted tube. These guidewires then pass over the narrow piece of vein. 

At this stage in proceedings, the small balloon is placed over one of the guidewires and is inflated to the appropriate size, depending entirely on the size of the given narrowed vein. The inflated balloon then stretches out the narrowed vein, and is stretched out as far as the overall size of the balloon. The stretching out of the vein typically lasts between 30 seconds and a minute and can be quite painful, so conscious sedation is offered to the patient if required. 

Why might one require a venoplasty?

People typically need to undergo a venoplasty procedure in order to correct restricted blood flow caused by a narrow piece of vein (stenosis). Occasionally, the various different blood vessels that make up a fistula can lead directly to this narrowing of the veins, which can cause problems such as swelling of the arm and/or bleeding. As the fistula, which allows the patient to have effective dialysis, is majorly affected due to this vein tightening and narrowing, a patient will need to have this problem treated as soon as possible in order to avoid potential clotting and/or failing of their fistula. 

What are the main risks involved?

A venoplasty procedure is, generally speaking, a very low-risk and safe procedure. However, there are various risks that the patients should be aware of prior to deciding to undergo a venoplasty. The main risks of the procedure include the following: 

  • rupture of the vein
  • bleeding
  • bruising
  • perforation (small hole in the vein)

What happens after a venoplasty?

The patient will need to be observed for two hours following a venoplasty, and if the patient shows no signs of discomfort or does not present any side effects, they can go home on that same day. Occasionally, a follow-up ultrasound might be necessary after six weeks have passed since the initial venoplasty procedure took place. All patients undergoing this procedure must be aware that is paramount that they have a family member of friend collect them at the hospital. Also, the patient should have someone stay overnight with them following the venoplasty. 

What to watch out for following a venoplasty

Patients who have undergone a venoplasty procedure should go straight to their nearest Accident and Emergency Department if they notice or experience severe pain, fever, a substantial amount of bruising or swelling, and/or any bleeding from the area where the procedure was performed. 

Which specialist performs a venoplasty?

Interventional radiologists are responsible for performing this procedure. 

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