Sharp needle recanalization for dialysis access occlusion: a single-center retrospective study

Long-term patency of arteriovenous fistulas (AVFs) is critical for hemodialysis patients. Sharp needle recanalization (SNR) is an image-guided percutaneous technique employed when conventional recanalization methods fail. This study evaluated the effectiveness of SNR in maintaining AVF patency.

We conducted a retrospective analysis of patients who underwent SNR for AVF occlusion between July 2014 and June 2023. Outcomes included technical success, assisted technical success, and patency rates (primary, assisted primary, and secondary). Complications and patient survival were assessed, with patency estimated using Kaplan-Meier analysis.

Thirty-three patients were included. Technical success was achieved in 79% of cases, while assisted technical success reached 100%. Primary patency decreased from 48% at 3 months to 9% at 24 months. Assisted primary patency was 73% at 3 months and 27% at 24 months. Secondary patency was highest, stabilizing at 71% at 24 months. Thrombosis occurred in 27% of patients, and 24% required creation of a new access tract. Nine patients died during follow-up, none related to the procedure.

SNR is an effective salvage option for AVF occlusion, offering durable secondary patency. The steep decline in primary patency underscores the importance of vigilant follow-up and timely reintervention to preserve dialysis access.