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Hemodialysis access thrombosis

Keith Bertram Quencer1, Rahmi Oklu2

  • 1Division of Interventional Radiology, Department of Radiology, University of Utah, Salt Lake City, UT, USA.

Cardiovascular Diagnosis and Therapy
|February 6, 2018
PubMed

Insights

Arteriovenous (AV) access thrombosis is a major complication for hemodialysis patients, often leading to lost access. Percutaneous declotting methods offer alternatives to surgery for managing AV access thrombosis.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Over 400,000 patients in the US rely on hemodialysis.
  • Arteriovenous (AV) access thrombosis is a common and serious complication.
  • Thrombosis leads to missed dialysis, hospitalizations, and permanent access loss.

Purpose of the Study:

  • To review the current percutaneous treatment options for AV access thrombosis.
  • To highlight the advantages of percutaneous methods over surgical thrombectomy.

Main Methods:

  • Review of existing literature on percutaneous declotting techniques.
  • Comparison of different percutaneous approaches: lyse-and-wait, thromboaspiration, pulse spray, and mechanical thrombectomy devices.

Main Results:

  • Percutaneous declotting is the preferred method for AV access thrombosis.
  • Multiple percutaneous techniques are available, each with potential benefits.
  • These methods aim to restore AV access patency and prevent permanent loss.

Conclusions:

  • Percutaneous declotting offers effective management for AV access thrombosis in hemodialysis patients.
  • A range of percutaneous techniques allows for tailored treatment strategies.
  • Minimizing complications like missed dialysis and access loss is crucial for patient care.

Keywords:
AV access thrombosisArteriovenous fistula (AVF)arteriovenous graft (AVG)pulse spray aided pharmacomechanical thrombolysis

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