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Outcomes of endovascular salvage of clotted arteriovenous access and predictors of patency after thrombectomy

Journal of Vascular Surgery Sep 10, 2019

Tan RY, Pang SC, Teh SP, et al. - Via reviewing records of 294 hemodialysis patients who underwent endovascular salvage of clotted arteriovenous (AV) access, the outcomes of endovascular salvage of clotted AV accesses were reported and potential predictors of poor patency rates after thrombectomy were investigated. Among these patients, 156 had AV fistula, whereas the remaining 138 had AV grafts (AVGs). As per outcomes, the endovascular technique can lead to the salvaging of most clotted AV accesses. Researchers observed technical and clinical success rates of 96.3% and 93.2%, respectively; major and minor complication rates of 0.7% and 9.9%, respectively. At 3 months, postthrombectomy primary, assisted primary, and secondary patency rates were 62.9%, 76.2%, and 77.6%, respectively and at 6 months, the respective rates were 43.9%, 59.5%, and 61.6%. As per multivariate Cox regression analysis, there was significant association of prior thrombosis within 90 days with loss of primary patency, assisted primary patency, and secondary patency. They observed a negative association of having an AVG with primary patency.
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