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Thrombolysis With Alteplase: A Non-Invasive Treatment for Occluded Arteriovenous Fistulas and Grafts
Article first published online: 9 JUL 2010
DOI: 10.1111/j.1525-1594.2010.01019.x
© 2010, Copyright the Authors. Artificial Organs © 2010, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
Additional Information
How to Cite
Tseke, P., Kalyveza, E., Politis, E., Giapraka, N., Andriopoulos, C., Balitsari, A., Papatzikos, L. and Stavgianoudakis, G. (2011), Thrombolysis With Alteplase: A Non-Invasive Treatment for Occluded Arteriovenous Fistulas and Grafts. Artificial Organs, 35: 58–62. doi: 10.1111/j.1525-1594.2010.01019.x
Publication History
- Issue published online: 13 JAN 2011
- Article first published online: 9 JUL 2010
- Received December 2009; revised January 2010.
- Abstract
- Article
- References
- Cited By
Keywords:
- Hemodialysis;
- Alteplase;
- Vascular access;
- Occlusion
Abstract
Thrombolysis with recombinant tissue type plasminogen activator (t-PA) has been successfully used in occluded arteriovenous (AV) hemodialysis grafts and tunneled catheters, especially as an adjunctive regimen to invasive or semi-invasive procedures. We performed a retrospective study to evaluate the effectiveness and outcomes of thrombolysis with t-PA in occluded AV hemodialysis accesses. We used low doses of t-PA in 40 cases of thrombosed AV fistulas and grafts. Primary success was noted in 55% of the cases ensuring patency rates of 30 and 90 days at 90.9 and 69.8%, respectively. Inflammation (increased C-reactive protein concentration) and shorter functioning time of AV access were independently associated with primary outcome, whereas there was no difference in outcome between AV fistulas or grafts. No major complications were noted. We conclude that the use of t-PA is a safe and easy treatment for clotted AV accesses that can be applied in an outpatient setting.