Thrombosed dialysis grafts: comparison of treatment with transluminal angioplasty and surgical revision.
OBJECTIVE
To compare the usefulness of transluminal angioplasty coupled with thrombectomy versus surgical revision coupled with thrombectomy in the restoration and maintenance of flow in thrombosed dialysis access grafts.


METHODS
Twenty-four patients undergoing 28 angioplasty procedures were retrospectively compared to 24 patients who underwent 33 surgical revisions with a minimum 12-month follow-up period. All patients had thrombosed upper-arm expanded polytetrafluoroethylene (ePTFE) grafts.


RESULTS
Initial success rates were 88% for angioplasty and 87% for surgery. Mean primary patency for angioplasty and surgery was 4.6 and 3.3 months, respectively. Mean secondary patency for angioplasty and surgery was 5.4 and 4.5 months, respectively. These differences were not statistically significant. A significantly shorter hospital stay and lower anesthesia requirement were noted in the angioplasty group.


CONCLUSIONS
Transluminal angioplasty coupled with Fogarty thrombectomy is an effective alternative to surgical revision for thrombosed dialysis access grafts. Angioplasty extends graft life, thereby preserving proximal venous outflow sites for future use.
Schwartz
C I
CI
Department of Cardiothoracic and Vascular Surgery, Chicago College of Osteopathic Medicine, Midwestern University, Ill.
McBrayer
C V
CV
Sloan
J H
JH
Meneses
P
P
Ennis
W J
WJ
D000800:Angioplasty, Balloon; D005260:Female; D006083:Graft Occlusion, Vascular / Q000601:surgery / Q000628:therapy*; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D012086:Reoperation; D017131:Thrombectomy; D014654:Vascular Patency