Chulalongkorn Medical Journal


Background : Percutaneous thrombolysis can be the effective method fortreatment of the hemodialysis graft.Objective : To retrospectively determine the clinical success rate ofpercutaneous management in thrombosed hemodialysis graft,the primary and secondary patency periods of graft afterpercutaneous management and complication at KingChulalongkorn Memorial Hospital from 1 January, 2007 to 30November, 2014.Materials and Methods : Twenty-nine PTFE grafts in 29 patients were referred to InterventionRadiology Unit for the percutaneous management of thrombosedhemodialysis graft. Angiographic reports and hospital medicalrecords were analyzed for the clinical success rate, proceduralrecord, angiographic finding, complication, and patency periodof the graft after treatment. Clinical success rate was determinedby complete graft restoration with a palpable thrill and return tonormal dialysis for at least one session. Patency period werecalculated with Kaplan-Meier method analysis to estimate graftsurvival probability with standard deviation.Results : Clinical success rate was achieved in 28 of 29 cases (96.55%).Neither major nor minor complication occurred. After successfulpercutaneous thrombolysis, 3 of 28 were loss to follow up.Consequently, 25 grafts were evaluated for patency periodswith the mean follow-up period of 593.6 ± 79.5 days(437.7 - 749.5 days). Mean patency period (mean survival time)after the 1st percutaneous thrombolysis of all 25 grafts werecalculated to 263.6 ± 49.4 days (166.9 - 360.7 days).Conclusion : Percutaneous thrombolysis is a safe and effective mean fortreatment of thrombosed hemodialysis graft at King ChulalongkornMemorial Hospital. Our success rate is comparable to the NationalKidney Foundation Dialysis Outcome Quality Initiative.



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