For Diana Parasram, dialysis is more than a medical routine — it is survival. Each session keeps her alive, doing the work her kidneys no longer can after she was diagnosed with kidney failure. Like thousands of patients, she began the demanding cycle of chronic hemodialysis, tethered to a machine that filters her blood several times a week.
Typically, patients receive a dialysis catheter inserted through the jugular vein in the neck and guided into the superior vena cava, just above the heart. But Diana’s journey was far from typical.
Over time, repeated dialysis access damaged her veins. Chronic hemodialysis can cause scarring and blockages, and in Diana’s case, the injury was severe. Efforts to reopen and restore her veins were unsuccessful. Imaging eventually confirmed there was not enough viable vein left to salvage.
With traditional access sites exhausted, she was referred by the nephrology team to interventional radiology for a more advanced solution.
In the meantime, Diana relied on a femoral vein catheter inserted in her groin — a temporary and high-risk option. Femoral catheters carry increased risks of infection and dangerous blood clots that can travel to the lungs. For Diana, it meant living with constant uncertainty while depending on the very treatment that sustained her life.
Faced with limited options, her medical team chose a specialised transhepatic approach — a complex procedure in which a catheter is inserted through the liver into the inferior vena cava, just below the heart. The technique is reserved for patients who have exhausted conventional access routes.
The procedure was successful. By the following day, Diana completed dialysis using the new catheter without complications. With the new access functioning effectively, the high-risk femoral catheter can now be safely removed.
Reflecting on the experience, Diana recalls the fear and uncertainty — the fasting before procedures, the anxiety that it might fail, and the tears when she thought she was running out of options. But she also speaks of gratitude. She is thankful for the doctors who remembered her case, reassured her, and remained determined to find a solution.
Today, she smiles with relief. Dialysis continues — but now, more safely. She remains hopeful that one day she will find a kidney donor and move beyond dialysis altogether.
Diana’s case highlights the complexity of managing long-term kidney failure and the critical role of collaboration between nephrology and interventional radiology. When standard access fails, innovation and expertise can mean the difference between continued treatment and life-threatening complications.
For patients like Diana, dialysis access is not just a medical device. It is hope. It is time. It is the promise of tomorrow. (Reworked from GPHC release)
