title: Prolonging the life of difficult hemodialysis access using thrombolysis, angiography, and angioplasty.
abstract: Prolonging the life of vascular access sites is one of the most pressing problems facing the nephrology team in the ongoing care of chronic hemodialysis patients. Thus, the ability to salvage a failing vascular access is important in any circumstance, but salvage is particularly critical in medically complicated situations. The following case presents just such a situation, one in which available access sites were limited and in which salvaging the function of a local access site obviated the need for major surgical intervention for more than 4 years. This example shows the efficacy of nonsurgical thrombolysis and the place of vascular radiology in the long-term preservation of access patency and follow-up care.
authors.affiliation: Division of Nephrology, Veterans Administration Medical Center, San Diego, CA 92161-1492, USA.
authors.forename: T W
authors.initials: TW
authors.lastname: Ziegler
authors.forename: A
authors.initials: A
authors.lastname: Safa
authors.forename: K
authors.initials: K
authors.lastname: Amarillis
authors.forename: V
authors.initials: V
authors.lastname: Callihan
authors.forename: A C
authors.initials: AC
authors.lastname: Roberts
authors.forename: K
authors.initials: K
authors.lastname: Valji
authors.forename: S B
authors.initials: SB
authors.lastname: Oglevie
mesh_terms: D000368:Aged; D000792:Angiography; D017130:Angioplasty; D002408:Catheters, Indwelling / Q000009:adverse effects*; D006801:Humans; D008297:Male; D006435:Renal Dialysis / Q000295:instrumentation*; D015912:Thrombolytic Therapy; D014654:Vascular Patency