The Place and Outcomes of Surgical Thrombectomy in Acute Arteriovenous Fistula Thrombosis
Journal Title: Journal of Ankara University Faculty of Medicine - Year 2020, Vol 73, Issue 3
Abstract
Objectives: The rate of arteriovenous fistula (AVF) thrombosis has been increasing in the population and there was yet no consensus on the salvage operation to be performed. Our aim is to demonstrate the success of the correct surgical procedure to be applied in the early period in patients with AVF thrombosis. Materials and Methods: Between November 2018 and June 2020, 29 patients who underwent surgical thrombectomy for acute AVF thrombosis in a single center were analyzed retrospectively. Preoperative characteristics, perioperative diagnostic tools, surgical procedures and surgical success were presented. Results: Surgical thrombectomy was performed for all patients. Additionally, balloon dilatation with an oversize fogarty balloon in the anastomosis area was performed for 8 (27.5%) patients, anastomosis revision was performed for 3 (10.3%) patients , type 2 stenosis zone excision and end-to-end anastomosis were performed for 5 (17.2%) patients. Technical success was achieved in 25 (86.2%) patients. A new fistula tract was created in 4 (13.7%) patients. Conclusion: According to these results, early surgical AVF thrombectomy performed by an experienced vascular surgeon provides sufficient success in the long term. In the preoperative period, it is very important to evaluate the patients in detail by ultrasonography and computed tomographic angiography and to determine the location and type of thrombus, presence and type of accompanying stenosis for successful patient selection and surgical plan.
Authors and Affiliations
Fatih Gümüş
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