Percutaneous Transluminal Angioplasty in Thrombosed Arteriovenous Fistulae
Author : D. Bestari, J. Nugroho
Upload Date : 19-04-2018
Background: Intervention of thrombus removal and repair of stenotic lesions remains the major goal toward access salvage and prolongation of patency rate. In the past, dialysis shunt thrombosis was regularly corrected with surgical thrombectomy. Percutaneous transluminal angioplasty (PTA) is now being used more frequently in the treatment of failed vascular access aiming at increasing the patency of arteriovenous fistula. The combination of this interventional approach with the mandatory angiographic procedure makes PTA a favourable first line treatment and appears to save a considerable number of surgical interventions.
Case: A 39 years old man reffered from Internal Medicine out-patient clinic due to failed hemodialysis. The patient complained his left forearm got swollen and rash on AV fistulae area. The patient had normal vital sign, no bruits in the area of AV fistulae. Thrombus was found along the fistulae from vascular doppler ultrasound. Patient was diagnosed with thrombosed AV fistulae and underwent PTA.
Discussion: PTA is a effective therapy for the majority of cases of thrombosed and stenotic fistulae. Advantages of this technique are minor complication rates, cost effectiveness, high technical success rate.
Conclusion: It has been reported a man 39 years old with thrombosed AVa fistulae. Thrombosed AV fistulae can cause life-threatening complications, therefore, early and accurate diagnosis and treatment is necessary. PTA is an efficacious method for the correction of stenosis of AVFs for hemodialysis, thus prolonging the patency of the fistulas.
KEYWORDS : Arteriovenous fistula, arteriovenous shunt, percutaneous transluminal angiography, PTA.