Year: 2018
Type: article
Study design: Observational Study
Abstract: INTRODUCTION AND AIMS: Thrombosed AV fistula revascuarization has poor technical success and patency rates.We wish to report our experience of selective salvaging failed AV fistula beyond 72 hours of occlusion based of doppler based anatomical criteria. METHODS: Retrospective analysis of prospectively collected data from July 2016- December 2017 was performed. Interventions in failed AV fistula presenting beyond 72 hours of occlusion with following anatomical criteria (doppler based) were included -a) more than 6 cm length of uniform diameter segment of matured fistula b) partially compressible thrombus (HALO Sign- Figure 1) in this segment, c) diameter of this segment more than10mm. Technical success, time to cannulation & primary patency was recorded. RESULTS: Ot of 52 revascularizations, 25 patients qualified for study criteria. Nine were failed Radiocephalic and 16 were failed brachiocephalic AVFs. Mean time to presentation was 33 days (10- 240 days). Surgical Thrombectomy was performed in all cases combined with additional procedures (figure 2). Technical success was 100%. Mean time to cannulation was 13 days (range 8- 22 days). Primary patency at 1 & 6 month was 100 & 92% respectively. CONCLUSIONS: Late surgical salvage of occluded fistula is technically feasible for anatomical suitable cases. Surgical thrombectomy combined with fixing inflow and outflow of the salvaged mature vein segment is the key.This approach enables early cannulation of matured segment of AV fistula therefore decreasing catheter days. Early primary patency is good.
Authors: himanshu verma, Mahendra Singh, D Sinha
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2803248049