Abstract
One of the most common problems in the blood-access for hemodialysis is clotting. Urokinase (UK) is routinely used as a thrombolytic agent for peripheral or cardiac thrombosis at present. Digital manipulation is added to UK-thrombolysis (UKTM) for the patients with clotted blood access for hemodialysis. The average age of those patients was 62.5 years. The total dose of UK was 180, 000 units in average. The overall recanalization rate was 71.4% (25/35), 75% (18/24) in patients with PTFE grafts, and 63% (7/11) in those with native arteriovenous fistulas. As complications following UKTM, ecchymoses were seen in 24/25 (92%), local pain in 23/25 (92%), re-clotting with in 24 hours in 2/35 (5.7%). No serious bleeding complications nor pulmonary embolism were seen. UKTM is a safe, easy, and effective modality to treat the clotting blood access as a first choice of treatment options.
