[imperial]

What are reasons that would require one to have to have fistula angioplasty w/balloon... and, reasons that one would need to have angioplasty with buttonhole? thanks.

[hollyster]

Originally Posted by imperial

What are reasons that would require one to have to have fistula angioplasty w/balloon... and, reasons that one would need to have angioplasty with buttonhole? thanks.

Angioplasty with a balloon is used to strech open the venous or arterial side of the fistula to reopen an occluded or narrowed area, a buttonhole would be used if the occlusion was at the site where the arterial and venous areas are connected.

[imperial]

a buttonhole would be used if the occlusion was at the site where the arterial and venous areas are connected.
What do you mean by the above.. thanks..... I was referring to a patient who had a buttonhole and needed angioplasty. Could the technique of insertion of needle, angle, for example, frequently, contribute to narrowing, etc.

[hollyster]

Originally Posted by imperial

a buttonhole would be used if the occlusion was at the site where the arterial and venous areas are connected.
What do you mean by the above.. thanks..... I was referring to a patient who had a buttonhole and needed angioplasty. Could the technique of insertion of needle, angle, for example, frequently, contribute to narrowing, etc.

Sorry for the confusion. Repeated needle insertions and sometimes just the pts inflammation or scarring tendencies will cause a narrowing in the area around the buttonhole. Angioplasty stretches the narrowed or scarred tissue back open. A stent could be placed to prevent the area from reoccluding.

[jnette]

Originally Posted by hollyster

Sorry for the confusion. Repeated needle insertions and sometimes just the pts inflammation or scarring tendencies will cause a narrowing in the area around the buttonhole. Angioplasty stretches the narrowed or scarred tissue back open.

Precisely.

This area is being stuck with rather large gauge needles three times a week.

Many patients will eventually produce some scarring and/or occlusion. This is very common, and really has nothing to do with the technique of needle insertion. Rotating needle insertion sites assists in avoiding pseudoanyeurisms, but as far as your question goes, I don't see that this would be a result of anyone's cannulating technique. Some ppl simply have poor veins to begin with. We have a lady who has just started using her fistula.. just several weeks now, and it is already occluded and had to go back to have another fistula placed.. first one just wasn't any good.

[RRN]

Originally Posted by jnette

Precisely.

This area is being stuck with rather large gauge needles three times a week.

Many patients will eventually produce some scarring and/or occlusion. This is very common, and really has nothing to do with the technique of needle insertion. Rotating needle insertion sites assists in avoiding pseudoanyeurisms, but as far as your question goes, I don't see that this would be a result of anyone's cannulating technique. Some ppl simply have poor veins to begin with. We have a lady who has just started using her fistula.. just several weeks now, and it is already occluded and had to go back to have another fistula placed.. first one just wasn't any good.

Diabetic?????? Notoriously sh**ty veins,,,,,,

[jnette]

Originally Posted by RRN

Diabetic?????? Notoriously sh**ty veins,,,,,,

Yeppers.

[imperial]

Thanks all.. The patient has a buttonhole and has the same site stuck... no rotating of sites.