Failed hemodialysis shunts. One year of experience with aggressive treatment.
Thirty-three failed hemodialysis access shunts in 26 patients were treated by streptokinase declotting and/or transluminal angioplasty over a period of one year. Seventeen (52%) were restored to function without surgical intervention; 7 (21%) had restoration of flow but required surgical correction of an underlying problem such as a pseudoaneurysm or vascular stenosis which resisted angioplasty; and 9 (27%) showed no improvement. The authors discuss their technique as well as causes of shunt failure, those lesions likely to be improved by declotting and/or angioplasty, and reasons for treatment failure and recurrent thrombosis.
D000792:Angiography; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D006801:Humans; D007267:Injections; D010690:Phlebography; D006435:Renal Dialysis; D013300:Streptokinase / Q000008:administration & dosage; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology
D013300:Streptokinase