Clinical Education
A weaker, intermittent or absent thrill may mean narrowing or thrombosis.
- An absent thrill
- Significant arm swelling
- Prolonged bleeding after dialysis
- Cold, painful or discoloured fingers
- Redness, pain or fever
How should I check it?
- Place your fingertips gently over the access without pressing hard.
- Learn the usual strength and area of the thrill.
- Notice if it becomes weaker, intermittent or absent.
When should I not wait?
- The thrill disappears completely.
- The arm suddenly becomes swollen.
- The fingers become cold, painful or discoloured.
- The access is red and painful, especially with fever.
Quick access check
| Finding | Possible meaning | What to do |
|---|---|---|
| Continuous gentle thrill | Familiar normal state | Continue daily checks |
| Weaker or intermittent thrill | Possible stenosis | Contact the dialysis unit promptly |
| No thrill | Possible clot or blockage | Do not wait until the next dialysis |
| Redness, pain or fever | Possible infection | Seek urgent care |
Note: If the thrill disappears, do not wait until your next dialysis session. Earlier treatment gives a better chance of saving the access.
References
- Sidawy AN, et al. J Vasc Surg. 2008;48(5 Suppl):2S–25S. View source
- Schmidli J, et al. Eur J Vasc Endovasc Surg. 2018;55(6):757–818. View source
This article is for health education only and does not replace individual medical assessment. Seek urgent care for acute symptoms.
Dr LiangVascular
Begin with a careful assessment.
Symptoms, examination and ultrasound findings are considered before treatment options are discussed.
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