Volume 4 Issue 1

Clinical Study: Logistic Challenges in Renal Access Salvage

Kristy Kehoe, Kirsty Hudson, Joanna Janczyk, Sharon Yen Ming Chan, Ben Cooper and Bryce Renwick*

Objective: To elicit the efficacy of hybrid thrombectomy procedures for renal access salvage.
Background: Fistula thrombosis is a well recognised complication of patients undergoing haemodialysis. Salvage of thrombosed fistulae requires urgent intervention. Hybrid thrombectomy and fistuloplasty procedures require the coordinated efforts of the anesthetic, interventional radiology and vascular surgical teams.
Methods: All emergency renal access referrals made to a renal access unit over a 12 month period were analysed. 21 patients in total underwent a combined or hybrid thrombectomy of thrombosed fistula.
Results: We found that prosthetic graft thrombosis accounted for the majority of thrombosed fistulae and moreover, were much more likely to re-thrombose following salvage relative to primary vein fistula. The number of patients subsequently undergoing dialysis on the same fistula successfully at 3 and 6 months dropped significantly.
Conclusion: When combined with significant re-intervention rate, these findings are suggestive of a need for enhanced renal access surveillance, more so in prosthetic grafts.
Keywords: Hybrid thrombectomy; Renal Salvage; Haemodialysis

Cite this Article: Kehoe K, Hudson K, Janczyk J, Ming Chan SY, Renwick B, et al. Logistic Challenges in Renal Access Salvage. Am J Anesth Clin Res. 2018;4(1): 001-003.

Published: 10 March 2018

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