THROMBOSED DIALYSIS GRAFTS - COMPARISON OF TREATMENT WITH TRANSLUMINAL ANGIOPLASTY AND SURGICAL REVISION

PURPOSE: To compare the usefulness of transluminal angioplasty coupled with thrombectomy versus surgical revision coupled with thrombectomy in the restoration and maintenance of flow in thrombosed dialysis acce ss grafts. MATERIALS AND METHODS: Twenty-four patients undergoing 28 a ngioplasty procedures were retrospectively compared to 24 patients who underwent 33 surgical revisions with a minimum 12-month follow-up per iod. All patients had thrombosed upper-arm expanded polytetrafluoroeth ylene (ePTFE) grafts. RESULTS: Initial success rates were 88% for angi oplasty and 87% for surgery. Mean primary patency for angioplasty and surgery was 4.6 and 3.3 months, respectively. Mean secondary patency f or angioplasty and surgery was 5.4 and 4.5 months, respectively. These differences were not statistically significant. A significantly short er hospital stay and lower anesthesia requirement were noted in the an gioplasty group. CONCLUSION: Transluminal angioplasty coupled with Fog arty thrombectomy is an effective alternative to surgical revision for thrombosed dialysis access grafts. Angioplasty extends graft life, th ereby preserving proximal venous outflow sites for future use.