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We Send Thrombosed AV Accesses to the Operating Room.

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Declotting thrombosed dialysis access can be done surgically or percutaneously. Percutaneous declotting is preferred for dialysis vascular access salvage due to fewer disruptions and less invasiveness.

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Thrombosed dialysis access poses a significant challenge for patients requiring hemodialysis.
  • Management options include open surgical declotting and percutaneous declotting.

Purpose of the Study:

  • To compare the efficacy and patient impact of open versus percutaneous declotting procedures for thrombosed dialysis access.
  • To guide nephrologists in selecting the optimal management strategy for vascular access salvage.

Main Methods:

  • Review of management strategies for thrombosed dialysis access.
  • Evaluation of percutaneous declotting procedures versus open surgical procedures.
  • Consideration of provider experience and local outcomes in decision-making.

Main Results:

  • Percutaneous procedures are less invasive and cause less disruption to patient and clinic schedules.
  • Percutaneous methods provide additional information on central vasculature.
  • Open surgical procedures may be necessary but percutaneous approaches are often preferred.

Conclusions:

  • Nephrologists should prioritize percutaneous declotting for thrombosed dialysis access when feasible.
  • Encouraging proficiency in percutaneous techniques among vascular surgeons and interventional radiologists can reduce open procedures.
  • Optimizing vascular access salvage through minimally invasive methods improves patient care and resource utilization.