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Declotting the Thrombosed Access

Keith B Quencer1, Tamir Friedman2

  • 1Division of Interventional Radiology, Department of Radiology, University of California, San Diego, San Diego, CA.

Techniques in Vascular and Interventional Radiology
|March 11, 2017
PubMed

Because a patent access is the lifeline for a dialysis patient, access declotting is extremely important. Before embarking on a declot, it is important to evaluate the patient for potential contraindications such as pulmonary hypertension, right-to-left shunts and access infection in order to be able to avoid potential complications such as symptomatic pulmonary embolism, stroke, and sepsis. Multiple methods to perform a percutaneous declot exist. Four common methods are described here. We also discuss how to avoid causing an arterial embolism and how to treat it if it does occur.

Keywords:
Clotted dialysis accessIatrogenic arterial embolismPulse-spray aided pharmacomechanical thrombolysis

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