ABSTRACT
Dialysis fistula thrombosis is the most common and dangerous complication which prevents proper dialysis therapy. The aim of this paper was to evaluate the influence of Clopidogrel on the incidence of early secondary thrombosis complications after restoring patency of fistula with surgical thrombectomy. The study included 30 patients. In 24 patients the method of surgical thrombectomy proved to be effective and they received a preventive dose of Clopidogrel [75 mg per 24h] for 28 days. In none of the patients early secondary thrombosis was recorded. Late secondary complications occurred in 11 patients 3 to 14 months after the surgical procedure. Treating acute thrombosis with surgical thrombectomy by means of Fogarthy catheter is still the most available and least expensive therapeutic method. Clopidogrel contributed considerably to the elimination of early secondary thrombosis complications in treated fistula.
Subject(s)
Arteriovenous Shunt, Surgical/adverse effects , Platelet Aggregation Inhibitors/administration & dosage , Renal Dialysis , Thrombectomy , Thrombosis/prevention & control , Ticlopidine/analogs & derivatives , Ticlopidine/administration & dosage , Adult , Aged , Clopidogrel , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Male , Middle Aged , Thrombosis/etiology , Thrombosis/surgery , Treatment OutcomeABSTRACT
Fistula thrombosis is the most common and dangerous complication resulting in vascular access insufficiency. The most "tricky" lesion of dialysis fistula is chronic thrombosis which occurs when only a short section of efferent vein becomes clotted and collateral circulation enabling further, limited in time functioning of dialysis fistula is created. In 7 chronic thrombosis patients subjected to treatment by means of endovascular recanalization, developed collateral vessels were surgically ligated to obtain single-canal blood flow. The recanalization procedure involved making a puncture, inserting a guide wire and performing balloon angioplasty. Simultaneously, 2 or 3 collateral veins were incised and ligated. The result obtained in all the 7 cases was considered successful as all fistulas remained a 100% patent 6 months after the procedure.
