Comparison of pharmacomechanical and surgical interventions for thrombosed native arteriovenous fistulas

Abstract

Background This study aims to compare success and patency rates of pharmacomechanical thrombectomy versus open surgical thrombectomy for thrombosed native arteriovenous fistulas. Methods A total of 96 patients (56 males, 40 females; mean age 61±11.7 years; range, 26 to 82 years) with a thrombosed native arteriovenous fistula between January 2016 and December 2018 were retrospectively analyzed. The patients were divided into two groups as pharmacomechanical thrombectomy (n=42) and open surgical thrombectomy (n=54). Primary failure rate and primary patency rate at 6 and 12 months were recorded. Results Of 42 patients in the pharmacomechanical thrombectomy group, 41 (98%) had additional interventions, and primary failure occurred in four patients (10%). Primary failure was seen in 15 (28%) patients in the surgical group. The primary patency rates at 6 and 12 months were significantly higher in the pharmacomechanical treatment group than the surgical group (85% vs. 67% and 78% vs. 55%, respectively; p<0.05). Conclusion Pharmacomechanical thrombectomy procedure yields higher primary patency rates than open surgical thrombectomy for thrombosed native arteriovenous fistula.