AI Article Synopsis

  • The study presents a modified lyse and wait technique for treating thrombosed dialysis fistulas, aiming for easier application and effective results.
  • A total of 84 patients underwent this procedure, with high success rates of 98.8% and minimal complications.
  • The technique demonstrated a median primary patency duration of 13.5 months, achieving primary and secondary patency rates of 66.6% and 80% after one year, respectively.

Article Abstract

Background: The lyse and wait technique is a percutaneous endovascular technique in the treatment of thrombosed dialysis fistulas. In this study, our aim was to introduce a more easily applicable modification of the lyse and wait technique and present our results.

Methods: A total of 84 patients (56 male; 66.6%), with a mean age of 61 years, were included in the study. The treatment was performed in patients presenting with dialysis fistula thrombosis no more than 1 week before the procedure, whose thrombosed segment length was less than 10 cm. A 27-G dental needle was inserted into the thrombosed segment under ultrasonography guidance, and 5 mg of alteplase was injected in a controlled manner. After about 6 to 12 h, the patients were taken to the angiography unit, and balloon angioplasty was performed.

Results: The technical and clinical success of the procedure was 98.8%. Technical and clinical failure occurred in only one patient. The median primary patency duration was 13.5 months. None of the patients had major complications. At the end of 12 months, the primary patency rate was 66.6%, and the secondary patency rate was 80%.

Conclusions: Our technique has shown to have high technical and clinical success and patency.

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http://dx.doi.org/10.1111/sdi.13047DOI Listing

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Article Synopsis
  • The study presents a modified lyse and wait technique for treating thrombosed dialysis fistulas, aiming for easier application and effective results.
  • A total of 84 patients underwent this procedure, with high success rates of 98.8% and minimal complications.
  • The technique demonstrated a median primary patency duration of 13.5 months, achieving primary and secondary patency rates of 66.6% and 80% after one year, respectively.
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Introduction: Different declotting techniques are available for acutely thrombosed arteriovenous hemodialysis fistulae (AVF). The aim of this single-center study was to compare immediate and follow-up results between surgical repair and a modified interventional lyse-and-wait technique characterized by prolonged local reaction times of recombinant tissue-plasminogen activator (rtPA).

Materials And Methods: We retrospectively analyzed medical records of 110 consecutively treated patients between the years 2003 and 2013.

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Introduction: Thrombosis is the most important access-related complication. Several declotting procedures have been suggested falling mainly into two categories; thrombolysis-dependent and thrombectomy-dependent.

Areas Covered: Seventeen studies after 2001 have been published on percutaneous treatment of thrombosed vascular access.

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Hemodialysis access thrombosis.

Cardiovasc Diagn Ther

December 2017

Division of Interventional Radiology, Department of Radiology, Mayo Clinic, Phoenix, AZ, USA.

For the over 400,000 patients in the United States dependent on hemodialysis, arteriovenous (AV) access thrombosis may lead to missed dialysis sessions, inpatient admissions and the need for placement of temporary dialysis catheters. It is also the leading cause of permanent access loss. Percutaneous declotting is generally preferred over surgical thrombectomy.

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Introduction: Local thrombolysis with a time of exposure to recombinant tissue plasminogen activator of 15 to 150 minutes is commonly used to declot acutely thrombosed hemodialysis fistulas. The duration of thrombolysis for the restoration of arteriovenous blood flow remains controversial. The aim of this study was to investigate the outcomes of long thrombolysis treatment (LTT, 3 hours or more) and short thrombolysis treatment (STT, less than 3 hours) in our institution.

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