Background: The optimal time for the salvaging of thrombosed hemodialysis grafts is controversial. This study was aimed at determining the optimal time related to the outcome of percutaneous pharmacomechanical thrombolysis (PMT) for the treatment of thrombosed arteriovenous graft (AVG).
Methods: This was a retrospective study of 191 hemodialysis patients who underwent PMT for thrombosed AVG from April 2014 to December 2021. Demographic data and details of the procedure were recorded. The procedural success rate related to the onset time of PMT was analyzed. The postinterventional circuit primary assisted patency rate was presented by the Kaplan-Meier curve.
Results: A total of 191 hemodialysis patients, 101 females and 90 males, were enrolled. Their median age was 66 years (interquartile range of 58-75 years). The majority type of thrombosed AVG was brachiocephalic loop graft (60.2%). The procedural success rate of PMT that was performed ≤ 48 h was 86.2%. There was a statistically significant procedural success rate of PMT in the group with an onset of treatment ≤ 48 h compared to > 48 h (odds ratio = 2.77; 95% confidence interval = 1.06, 7.28; p = 0.037). The median postintervention circuit primary assisted patency in the group of treatment ≤ 48 and > 48 h was 7.3 and 3.9 months (p = 0.023), respectively.
Conclusion: From this study, the optimal time of PMT for treatment of thrombosed AVG should be within 48 h after onset of thrombosis for enhancing procedural success and patency rates.
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