Triumph of Percutaneous Transluminal Angioplasty in Acute AVF Thrombosis Cases
DOI:
https://doi.org/10.11594/jk-risk.06.1.8Keywords:
Acute arteriovenous fistula (AVF) thrombosis, arteriovenous fistula (AVF), percuta-neous transluminal angioplasty (PTA)Abstract
Background: Arteriovenous fistula (AVF) remains the vascular acces of choice for hemodialysis due to minimal side effects; however, the incidence of thrombosis remains a significant concern, with reported rates reaching up to 39%. For patients on hemodialysis, percutaneous transluminal angioplasty (PTA) is commonly performed to treat acute thrombosis arteriovenous fistula.
Case Description: Two patients presented with acute thrombosis of an arteriovenous fistula at Saiful Anwar Hospital, Malang. The first patient was a 60-year-old female with acute AVF thrombosis and concomitant central venous stenosis at left upper extremity. While second patient was a 78-year-old male with AVF thrombosis as well as a thrombus in the left artery radialis sinistra. Both cases presented with swelling of the left upper extremity and a palpable left arteriovenous fistula (AVF) with an inadequate thrill. Both patients were managed by the Acute Thrombosis Team at Saiful Anwar Hospital, Malang, and underwent Percutaneous Transluminal Angioplasty (PTA) within 48 hours of AVF thrombosis onset. This timely intervention was made possible due to awareness of the signs and symptoms of acute AVF thrombosis by the patients and/or healthcare providers. Post-procedural angiography following PTA demonstrated restoration of optimal blood flow in both cases.
Conclusion: Percutaneous transluminal angioplasty (PTA) has been shown to be a safe and effective method for managing acute AVF thrombosis. One of the key determinants of successful PTA outcomes is the timing of the intervention.
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