DIFFERENT PROCEDURES FOR OCCLUSION OF A-V CONDUITS - SALVAGE OR ABANDONMENT

Within a period of 4 years we have followed-up all salvage procedures (n = 235) on A-V conduits in patients with end-stage renal disease to support our consequent treatment in restoring any non-functional fistu las if possible. In 52% thrombectomy was performed combined with addit ive corrections of the underlying reason of occlusion. In 27% we did n ot find any cause for shunt thrombosis. A prophylactic revision in fis tula dysfunction was carried out in 15%. The primary patency rates aft er 12 months in Cimino fistulas and PTFE implants were 83% and 52%, re spectively. Aggressive salvage therapy resulted in a secondary patency rate of 94% and 87% (Kaplan-Meier life table analysis). In conclusion , these data support our strategy of aggressive salvage procedures for A-V conduits instead of early abandonment.