ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation

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Combine of transcatheter thrombolysis and percutaneous transluminal angioplasty in treatment of acute thrombosis of arteriovenous fistula

  

  • Online:2020-08-28 Published:2020-08-22

Abstract: Objective:To evaluate the efficacy of transcatheter thrombolysis and percutaneous transluminal angioplasty(PTA) in treatment of acute thrombosis of arteriovenous fistulas(AVF) using a radial artery approach.
Methodology:Clinical data of 102 hemodialysis patients with acute thrombosis in AVF,who were admitted to Aviation General Hospital during January 2013 to December 2018 were retrospectively analyzed.All patients were diagnosed with AVF thrombosis by preperative vascular ultrasound and  received transcatheter thrombolysis with PTA using a radial artery approach.AVF patency was assessed after 12 months.The patency was evaluated by KaplanMeier analysis.
Results:Thrombolysis with PTA was performed at 6 to 72 h after diagnosis of AVF occlusion due to acute thrombosis,and AVF patency was restored in all patients.AVF stenosis was proved in 92 patients(902%),After 12 months,the primary and secondary patency rates were 784%and 959%,respectively.For type Ⅰ stenosis,primary patency was achieved in 34 of 44 patients(744%) and secondary patency was achieved in 40 of 44 patients(909%).For type Ⅱ stenosis,primary patency was achieved in 38 of 48 patients(833%) and secondary patency was achieved in 48 of 48 patients(100%).Secondary patency rate of 12 months was significantly differed between type Ⅰ and type Ⅱ stenosis(P=0035),but not primary patency rate(P=0292)
Conclusion:
This study suggested that transcatheter thrombolysis and PTA through radial artery approach was a safe and effective method in treatment of acute thrombosis in AVF in hemodialysis patients.