Long-term results of surgical treatment of arteriovenous fistula thrombosis using local intravenous catheter thrombolysis

The aim was to evaluate the long-term results of surgical treatment of arteriovenous fistula (AVF) thrombosis using the method of local intravenous catheter thrombolysis. Material and methods. Our study analyzed clinical data from 158 patients with AVF thrombosis from 2021 to 2024. Two groups of patients were formed: Group 1 (main group) included 77 patients who underwent the first stage of our developed method, “local intravenous catheter thrombolysis,” and the second stage, balloon angioplasty of the AVF. Group 2 (control group) included 81 patients who underwent surgical thrombectomy of the AVF. The study examined patient demographic parameters, key AVF parameters, and cumulative AVF patency to determine the duration of permanent vascular access function for 6 months and 1 year after surgery. Laboratory parameters were analyzed during 1 year of follow-up to identify predictors of the risk of AVF thrombosis. Results. In our study, the cumulative patency of the AVF in the study group over 6 months of observation was 84.4%, while in the control group it was 82.7%. The cumulative patency of the AVF in the study group over 1 year after surgery was 43.6%, while in the control group it was 39.2%, which is statistically significantly lower compared to the study group (p = 0.05). The identified laboratory parameters, such as phosphorus, alkaline phosphatase, glucose, and iron levels in the blood, in patients on program hemodialysis can serve as prognostic risk factors for AVF thrombosis. Conclusions. The method we developed is effective in improving the short-term and long-term patency of arteriovenous fistulas with thrombosis.