For Diana Parasram, dialysis is not simply a medical treatment — it is the lifeline that keeps her alive.
After being diagnosed with kidney failure, Parasram began the long and difficult journey faced by thousands of patients whose kidneys can no longer function on their own. Dialysis, a procedure that removes waste and excess fluid from the blood, became essential to sustaining her life.
For most patients undergoing hemodialysis, a catheter is inserted through the jugular vein in the neck and guided into the superior vena cava (SVC), the large vein just above the heart. This access point allows doctors to efficiently perform dialysis treatments.
However, Parasram’s case proved far more complicated.
Over time, chronic hemodialysis can take a toll on the veins used for access. Repeated catheter placements and long-term treatment can cause scarring, narrowing, or even complete blockage of the veins.
Parasram experienced exactly this complication.
Years of dialysis access attempts led to significant injury to her veins, leaving doctors with very limited options. Medical teams attempted to restore access through various procedures designed to assess and reopen blocked veins.
But imaging tests revealed a troubling reality: there was not enough viable vein remaining to salvage.
With conventional access sites no longer possible, the nephrology team referred Parasram to specialists in interventional radiology for a more advanced and unconventional solution.
At the time, Parasram depended on a dialysis catheter placed in the femoral vein in her groin — a temporary option typically used only when other access sites are unavailable.
Femoral catheters carry significant risks. They are associated with a higher likelihood of infection and dangerous blood clots that can travel to the lungs, potentially causing life-threatening complications.
For Parasram, this meant living with constant uncertainty while relying on the very treatment keeping her alive.
Faced with these challenges, the medical team decided to perform a specialised transhepatic dialysis access procedure — a highly technical intervention reserved for patients who have exhausted traditional vascular access routes.
In this procedure, doctors insert a catheter through the liver and guide it into the inferior vena cava (IVC), the major vein located just below the heart. The technique allows dialysis to continue when all other access points have failed.
The procedure was successfully carried out by the interventional radiology team.
By the following day, Parasram was able to undergo dialysis using the new catheter without complications. With the new access functioning effectively, doctors can now safely remove the high-risk femoral catheter.
Reflecting on her experience, Parasram described the emotional toll of living with such uncertainty.
She spoke about the fear before each procedure, the hunger from fasting beforehand, and the constant worry that the next attempt might not work. At times, she feared she was running out of options.
But alongside that fear came deep gratitude.
Parasram expressed appreciation for the medical team who remembered her case, reassured her throughout the process, and remained determined to find a solution.
Today, she says she feels relief knowing that dialysis can continue safely. She also remains hopeful that one day she will receive a kidney donor.
Parasram’s case underscores the complex challenges involved in managing long-term kidney failure and the critical importance of collaboration between medical specialties.
The coordinated efforts of nephrology and interventional radiology made it possible to find an innovative solution when standard dialysis access options had been exhausted.
For patients like Diana Parasram, dialysis access represents far more than a medical device.
It represents hope, time — and the promise of tomorrow.
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