Percutaneous Management of Thrombosed Dialysis Access Grafts

Thuong Van Ha

doi:10.1055/s-2004-833680

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Semin intervent Radiol 2004; 21(2): 77-81
DOI: 10.1055/s-2004-833680

Percutaneous Management of Thrombosed Dialysis Access Grafts

Thuong Van Ha¹

¹Radiologist, Department of Radiology Section of Vascular and Interventional Radiology, The University of Chicago, Chicago, Illinois

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Publication Date:
13 September 2004 (online)

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This article reviews current concepts in the percutaneous management of thrombosed polytetrafluoroethylene (PTFE) dialysis access grafts. The maintenance of dialysis access grafts remains a challenging task. Graft surveillance is critical in the prevention of graft thrombosis to prolong graft survival. Once a graft is thrombosed, surgical and percutaneous options are available for restoration of flow. There has been an evolution in the percutaneous treatment of thrombosed dialysis access grafts during the last 20 years, with refinement of pharmacomechanical techniques, allowing for safe and efficacious restoration of flow in thrombosed grafts. There has been emergence of alternative thrombolytic agents to urokinase, which was withdrawn from the United States in late 1998 and recently reintroduced. These alternative thrombolytic agents have similar outcomes compared with urokinase, with the additional advantage of being less expensive. In addition, several mechanical devices, which were popular briefly when urokinase was unavailable, are available currently for use within grafts, with similar success, although their prices have limited widespread use.

KEYWORDS

Grafts - hemodialysis - thrombosis - grafts - thrombolysis - fibrinolytics

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Thuong Van HaM.D.

Department of Radiology, Section of Vascular and Interventional Radiology, The University of Chicago

5841 South Maryland Avenue, Chicago, IL 60637

Email: tgvanha@radiology.bsd.uchicago.edu