Pharmacomechanical thrombolysis for the treatment of thrombosed native arteriovenous fistula: a single-center experience.

Background: Native arteriovenous fistula is one of the important routes for hemodialysis patients because of increased long-term survival and preservation of quality of life. We reported on a single-center experience with using pharmacomechanical thrombolysis for the treatment of thrombosed native arteriovenous fistula.
Material/methods: This was a retrospective study of 12 hemodialysis patients (8 males and 4 females) with 14 thrombosed distal forearm Brescia-Cimino radiocephalic fistulas who were referred for pharmacomechanical thrombolytic treatment in the intervention unit of the Radiology Department, from 1 January 2010 to 30 December 2011. Demographic data, technical success rates, clinical success rates and complications were evaluated. The patency was evaluated by Kaplan-Meier analysis.
Results: The technical and clinical success was found in 12 thrombosed fistulas. Only 3 procedures had minor complications including small amounts of adjacent soft tissue hematoma. There were no procedure-related major complications. The primary patency rates at 6 and 12 months were 67% and 50%. The secondary patency rates at 6 and 12 months were 75% and 67%.
Conclusions: Pharmacomechanical thrombolysis is a minimally invasive, effective, durable, and safe procedure for the treatment of thrombosed native arteriovenous fistula. This procedure can be considered as an alternative treatment for thrombosed dialysis fistulas.