Publication: Catheter-directed thrombolytic infusion for thrombosed arteriovenous fistulas with a large clot burden: A case series
Issued Date
2021-01-01
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ISSN
11297298
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2-s2.0-85105707684
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Vascular Access. (2021)
Suggested Citation
Ittikorn Spanuchart, Bakhtiar Amin, Adrian Sequeira, Chiranjiv Virk, Kenneth Abreo, Bharat Sachdeva Catheter-directed thrombolytic infusion for thrombosed arteriovenous fistulas with a large clot burden: A case series. Journal of Vascular Access. (2021). doi:10.1177/11297298211011916 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/78745
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Title
Catheter-directed thrombolytic infusion for thrombosed arteriovenous fistulas with a large clot burden: A case series
Abstract
Arteriovenous fistula (AVF) thrombosis occurs less often when compared to arteriovenous grafts. Since the number of AVFs has increased in the United States, AVF thrombosis is seen more frequently today. AVF thrombectomy can be tedious, requires physician ingenuity, and many times results in failure. Substantial clot burden in megafistulas and aneurysms is considered a relative contraindication to endovascular thrombectomy. Usually, it results in surgical referral for open thrombectomy or, at times, abandonment of the fistula altogether. Herein, we describe the technique, results, and cautions of combining a continuous infusion of recombinant tissue plasminogen (rTPA) followed by angioplasty of the culprit stenotic lesion that was successful in opening five of six AVFs with a substantial clot burden.