Northstar Vascular Surgery Center of Texas
When you rely on dialysis to stay healthy, your vascular access is your lifeline. If your fistula or graft suddenly stops working, treatments can be delayed or cancelled — and that can feel frightening.
One of the most effective ways to quickly fix a clotted access is a procedure called thrombectomy. At Northstar Vascular Surgery Center of Texas, we specialize in minimally invasive thrombectomy to restore blood flow and get you back to your regular dialysis schedule as soon as possible.
You can learn more about our full range of procedures
What Is a Thrombectomy?
A thrombectomy is a procedure that removes a blood clot (thrombus) from your dialysis access. Clots can form inside an arteriovenous (AV) fistula or AV graft when blood flow slows down, usually because the access has narrowed over time.
During a thrombectomy, a vascular specialist:
- Locates the clot with imaging
- Uses specialized catheters and devices to break up and remove the clot
- Treats any underlying narrowing so blood can flow normally again
In most cases, this is done as an outpatient procedure using local anesthesia and light sedation.
For a general overview of AV Fistula vs. AV Graft — What’s the Difference?
Why Does a Dialysis Access Clot?
Clotting (thrombosis) usually doesn’t happen out of nowhere. It’s often the end result of a narrowing (stenosis) somewhere along the access.
Common reasons an access may clot include:
- Narrowing inside the fistula or graft
- Repeated needle sticks in the same area
- High pressures during dialysis
- Low blood pressure or dehydration
- Long-standing access that needs maintenance
The good news: if treated early, most clotted accesses can be opened and saved.
For more on early warning signs, review:
My Access Isn’t Working—When to Call Your Doctor vs. Go to the ER
Signs Your Dialysis Access May Be Clotted
You should contact a vascular specialist right away if you notice:
- Loss of thrill (the usual “buzzing” feeling)
- Loss of bruit (the “whooshing” sound when listened to with a stethoscope)
- Sudden swelling or firmness along the access
- New pain in the access arm
- Difficulty placing needles or completing treatment
- Your dialysis center reports very low blood flow or cannot run dialysis through the access
If your access stops working but you do not have severe pain, fever, or heavy bleeding, many clots can be treated directly in our outpatient center rather than in the emergency room.
How a Thrombectomy Works at Northstar
Every patient is different, but most thrombectomy procedures follow a similar step-by-step approach.
1. Evaluation and Imaging
First, our team performs a physical exam and may use ultrasound or X-ray imaging (fistulogram) to:
- Confirm the location of the clot
- Identify any narrowed areas
- Plan the safest way to restore flow
This evaluation is similar to what we use for other access procedures described on our Procedures page.
2. Removing the Clot
Next, we guide a small catheter into the access under imaging. Depending on your situation, we may:
- Use mechanical devices that break up and remove the clot
- Use a balloon catheter to move or dislodge clot
- Use a small amount of clot-dissolving medication when appropriate
These techniques are designed to be fast, targeted, and minimally invasive.
3. Fixing the Narrowing (Angioplasty)
Because clots often form where an access has narrowed, we usually perform angioplasty during the same procedure. This involves:
- Inflating a small balloon inside the narrowed segment
- Widening the vessel so blood can flow more freely
- Occasionally placing a stent if needed for long-term support
Northstar combines angioplasty and thrombectomy in a single visit whenever possible to both fix the clot and address the underlying problem.
4. Recovery and Return to Dialysis
Most thrombectomy procedures:
- Take about 45–90 minutes
- Use local anesthesia and light sedation
- Allow patients to go home the same day
Your dialysis center will be notified of the results, and in many cases, dialysis can resume the same day or the very next day, depending on your schedule.
Is a Thrombectomy Safe?
Thrombectomy is a routine, well-established procedure that is performed frequently at Northstar. Complications are uncommon, and early treatment greatly improves the chance of saving your existing access.
Our team focuses specifically on dialysis access care, which means:
- Dedicated vascular access specialists
- Imaging-guided precision
- Same-day appointments whenever possible
- Close coordination with your nephrologist and dialysis center
Do I Need to Go to the ER for a Clotted Access?
Not always.
You should go straight to the emergency room or call 911 if you have:
- Heavy or uncontrolled bleeding
- Severe pain in the access or arm
- Fever, chills, or signs of infection (redness, warmth, drainage)
- Chest pain, shortness of breath, or feeling very unwell
However, if your main symptom is loss of thrill or poor blood flow and you feel otherwise stable, an outpatient thrombectomy at Northstar is often the safest, fastest option.
For guidance on when to call your doctor versus when to go to the ER
How to Protect Your Access After a Thrombectomy
After your clot is removed and blood flow is restored, good daily habits can help prevent future problems.
Helpful tips:
- Check your access every day for a strong thrill
- Avoid sleeping on your access arm
- Do not carry heavy bags or have blood pressure checks on that arm
- Rotate needle sites during dialysis
- Follow your dialysis team’s advice on fluid balance and blood pressure
- Call early if you notice changes in thrill, swelling, or discomfort
For more education on access types and care, you can revisit:
AV Fistula vs. AV Graft — What’s the Difference?
Trusted patient resources on vascular access are also available from national organizations such as:
- National Kidney Foundation – Vascular Access
- NIDDK – Hemodialysis Access
Why Patients Choose Northstar Vascular Surgery Center of Texas
Patients and dialysis centers across the Dallas–Fort Worth area trust Northstar because we offer:
- Same-day evaluations for clotted or poorly functioning accesses
- Minimally invasive thrombectomy and angioplasty
- A modern, outpatient setting focused on patient comfort
- On-site imaging and anesthesia support
- A team that works directly with your nephrologist and dialysis unit
Learn more about our services:
Procedures
Blog
Schedule a Thrombectomy or Access Evaluation
If your dialysis access suddenly stops working, feels different, or has lost its thrill, don’t wait. Early treatment can often save the fistula or graft and prevent interruptions in your dialysis schedule.
To schedule a same-day access evaluation:
- Call 817-714-8262
- Visit our Contact page
- Email: [email protected]
Northstar Vascular Surgery Center of Texas
5901 South Hulen
Fort Worth, Texas 76132
Frequently Asked Questions: Thrombectomy & Dialysis Access
What is a thrombectomy?
A thrombectomy is a minimally invasive procedure that removes a blood clot from an AV fistula or graft to restore blood flow and allow dialysis to continue safely.
How do I know if my access is clotted?
Loss of thrill or bruit, new swelling, pain, or the inability to complete dialysis treatments are all warning signs. If you notice these symptoms, contact a vascular specialist right away.
Is a thrombectomy painful?
Most patients feel only mild pressure. The procedure is typically done with local anesthesia and light sedation to keep you comfortable.
How soon can I return to dialysis after a thrombectomy?
Many patients are able to return to dialysis the same day or the next day, depending on the treatment schedule and your dialysis center’s recommendations.
Can a clotted access always be saved?
Not always, but when the clot is treated early and the underlying narrowing is corrected, a thrombectomy has a high success rate in restoring function.
How can I prevent my access from clotting again?
Daily thrill checks, protecting your access arm, controlling blood pressure, and reporting changes early all help reduce the risk of future clots.
