MECHANICAL THROMBOLYSIS FOR THE TREATMENT OF THROMBOSED HEMODIALYSIS ACCESS GRAFTS

PURPOSE: To evaluate the data acquired over 2 1/2 years regarding the use of mechanical thrombolysis as the routine, preferred treatment for thrombosed access grafts in a large patient population undergoing hem odialysis. MATERIALS AND METHODS: Mechanical thrombolysis was performe d in 1,176 cases. Data were collected on the success rate, complicatio n rate, long-term patency, and presence and location of stenosis. The results of mechanical thrombolysis were compared with those of surgery . All data were collected prospectively. RESULTS: Thrombosed grafts we re treated successfully in 1,123 of 1,176 cases (95%). Minor complicat ions occurred in 34 cases (3%). Venous stenosis was present in 1,054 c ases (90%). Long-term patency rates were 74% at 30 days, 52% at 90 day s, and 17% at 360 days. The thrombosis rate per patient per year and t he number of patients who required graft revision or replacement decre ased in comparison with the results obtained with surgical treatment. CONCLUSION: Mechanical thrombolysis was effective, quick, and safe. Pe rcutaneous treatment should be adopted as the treatment of choice for thrombosed hemodialysis access grafts.