Abstract
Nineteen cases of mal-functioning dialysis-access fistulas were treated with a combination of surgical throm bectomy and balloon dilation. Four cases with stenosis and fifteen with occlusions were included in this series.
The thrombectomy and the balloon dilation were performed sequentially at a surgically exposed proximal vein. Angioplasty balloons 5mm in diameter and 2cm in length were used for dilation, and up to 3 inflations of 1 minute each were employed.
To prevent thrombosis, 3, 000 IU of heparin and 10mg of argatroban were administered intravenously.
The initial success rate was 94.7% and the patency rate after one week was 84.2%, after 30 days 73.7%, and after 90 days 73.7%. No complications were observed.
Balloon dilation of a malfunctioning hemodialysis shunt, even when stenose, is the procedure of choice.
