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Related Experiment Video

Updated: Jul 16, 2026

A Murine Model of Hemodialysis Access-Related Hand Dysfunction
08:39

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Published on: May 31, 2022

SALVAGE OF THROMBOSED ARTERIOVENOUS ACCESS: OUTCOMES FROM A DEDICATED VASCULAR ACCESS CENTER.

Marta Machado1, Paulo Almeida1, Paulo Teles1

  • 1Grupo de Estudos Vasculares (GEV), Porto, Portugal.

Annals of Vascular Surgery
|July 14, 2026
PubMed
Summary

Vascular access thrombosis in hemodialysis patients can be effectively managed in specialized centers. A dedicated vascular access center with integrated surgical-endovascular expertise achieves high success rates in salvaging thrombosed arteriovenous fistulas and grafts.

Keywords:
arteriovenous fistulaarteriovenous graftendovascularpatencythrombectomythrombosisvascular access

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Vascular access thrombosis is a primary cause of arteriovenous (AV) access loss in hemodialysis patients.
  • Optimal treatment strategies for AV access thrombosis remain a subject of debate.
  • This study investigates the outcomes of treating AV access thrombosis within a specialized vascular access center.

Purpose of the Study:

  • To evaluate the effectiveness of a specialized vascular access center in managing thrombosed AV access.
  • To analyze technical and clinical success rates, stenosis patterns, and access-specific outcomes.
  • To compare patency rates for different types of AV access after thrombectomy.

Main Methods:

  • Retrospective cohort study of 152 patients with thrombosed AV fistulas (AVF) or AV grafts (AVG) referred to a specialized center (2017-2021).
  • Integrated surgical-endovascular approach utilized.
  • Kaplan-Meier analysis for primary, assisted primary, and secondary patency at 3, 6, and 12 months.

Main Results:

  • Thrombosis incidence increased during the COVID-19 pandemic (5.5% to 9.6%).
  • Open thrombectomy was the predominant procedure (90.8%), with high success rates (91.2% clinical, 89.2% technical).
  • Outflow stenosis was common (76.3%), treated with high-pressure balloon angioplasty (85.4%). Superior 3-month primary patency observed for autologous AVF (78.3%). 12-month primary patency was 50.0% and primary assisted patency was 58.6%.

Conclusions:

  • A dedicated vascular access center with integrated hybrid capabilities achieves high outcomes in thrombosed AV access salvage.
  • Specialization, accessibility, and combined surgical-endovascular expertise are crucial for managing dialysis access emergencies.
  • AV access thrombosis is a manageable complication, not an endpoint, within this specialized model.