THE IMPORTANCE OF TIMING OF SURGERY FOR HEMODIALYSIS VASCULAR ACCESS THROMBECTOMY

The effect of delay in thrombectomy of occluded hemodialysis accesses was examined to determine whether a critical period exists during whic h a salvage procedure was more likely to be successful. A total of 1,1 26 vascular access surgeries between January 1, 1989, and December 31, 1994, were analyzed. No period of delay in thrombectomy was found whe n it was possible to say with certainty that an access could not be sa lvaged, although success was greatest in the first 48 h. Autogenous fi stulas were less likely to be salvaged and surgery was unlikely to be successful if performed later than the day of thrombosis. However, gra fts were likely to undergo successful thrombectomy even 3 days after t hrombosis. Overall when the delay was more than 3 weeks after thrombos is, a new access was more likely to be constructed than the thrombosed access was to be successfully declotted.