Percutaneous treatment of thrombosed hemodialysis arteriovenous fistulas: use of thromboaspiration and balloon angioplasty

BACKGROUND: Endovascular strategies have been used to manage patients with thrombosed vascular access for hemodialysis. We analyzed primary success rate and patency rates of balloon angioplasty following mechanical thrombectomy for the treatment of thrombosed native arteriovenous fistulas. METHODS: This was a retrospective study of 24 patients with thrombosed native arteriovenous fistulas who were referred for treatment in the intervention unit of the Radiology Department. All patients had been performed percutaneous thrombo-aspiration and balloon angioplasty. Technical and clinical success rates as well as the 6th and 12th months primary and secondary patency of fistulas were evaluated. RESULTS: Technical and clinical success was 83%. In the 6 of 20 patients, early re-thrombosis were detected. Patent AVF with primary and secondary patency rates at 6 and 12 months was 55%-40%. The secondary patency rates at 6 and 12 months were 75% and 70%. CONCLUSION: Mechanical thrombectomy with balloon angioplasty is a minimally invasive and effective procedure for the treatment of thrombosed native arteriovenous fistula. Advantages of this technique are minor complication rates, cost effectiveness, high technical success rate.