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Early percutaneous thrombolysis for AVF thrombosis: symptom duration as a predictor of endovascular salvage    
Yazarlar (2)
Dr. Öğr. Üyesi İsmail TAŞKENT Dr. Öğr. Üyesi İsmail TAŞKENT
Kastamonu Üniversitesi, Türkiye
Dr. Öğr. Üyesi Güler Gülsen ERSOY Dr. Öğr. Üyesi Güler Gülsen ERSOY
Kastamonu Üniversitesi, Türkiye
Devamını Göster
Özet
Arteriovenous fistula (AVF) thrombosis remains a critical complication in hemodialysis (HD) patients, often leading to treatment delays and requiring urgent intervention. While endovascular therapy (EVT) is commonly employed, less invasive strategies such as percutaneous thrombolytic therapy are gaining attention due to their potential to restore patency and avoid more complex procedures. This study assessed the effectiveness of percutaneous thrombolytic therapy in acute AVF thrombosis and explored key predictors associated with the need for subsequent endovascular intervention. This retrospective study included 42 patients who underwent ultrasound-guided percutaneous thrombolytic therapy using low-dose alteplase (3-5 mg). Technical and clinical success, complication rates, and the need for additional EVT were assessed. Statistical analyses including logistic regression and ROC analysis were used to determine independent predictors for EVT. The clinical success rate was 97.6%, with 69% of patients achieving AVF patency without EVT. Symptom duration emerged as the strongest predictor for EVT; patients with symptoms > 2.5 days had significantly higher EVT rates (p = 0.01). Each additional day of symptoms increased the odds of requiring EVT by 88.5% (OR = 1.885, p = 0.012). Female patients were also more likely to require EVT than males (p = 0.005). No significant associations were found for age, BMI, or fistula characteristics. Percutaneous thrombolytic therapy is a highly effective and minimally invasive option for acute AVF thrombosis. Symptom duration > 2.5 days is a key threshold predicting the need for EVT, highlighting the critical importance of early intervention. These findings may inform clinical decision-making and optimize access salvage strategies in dialysis patients.
Anahtar Kelimeler
Arteriovenous fistula | Thrombosis | Hemodialysis | Percutaneous thrombolytic therapy | Endovascular intervention
Makale Türü Özgün Makale
Makale Alt Türü ESCI dergilerinde yayınlanan tam makale
Dergi Adı CVIR Endovascular
Dergi ISSN 2520-8934 Wos Dergi Scopus Dergi
Dergi Tarandığı Indeksler ESCI
Makale Dili İngilizce
Basım Tarihi 08-2025
Cilt No 8
Sayı 67
Sayfalar 1 / 7
Doi Numarası 10.1186/s42155-025-00587-2
Makale Linki https://doi.org/10.1186/s42155-025-00587-2