Indian Journal of Radiology Indian Journal of Radiology  

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Year : 2015  |  Volume : 25  |  Issue : 3  |  Page : 244-245
USG-guided needle-directed pulse-spray pharmaco-mechanical thrombolysis of hemodialysis grafts/fistula: A novel technique

1 Department of Interventional Radiology, Sakra World Hospital, Bangalore, Karnataka, India
2 Department of Radiology, Apollo Hospitals, Bangalore, Karnataka, India
3 Department of Nephrology, Apollo Hospitals, Bangalore, Karnataka, India

Correspondence Address:
Dr. KS Amitha Vikrama
Sakra World Hospital, 52/2 and 52/3, Devarabeesanahalli, Varthur Hobli, Bangalore - 560 103, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-3026.161442

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The incidence of end-stage renal disease is significantly increasing and most patients who require renal transplantation are undergoing hemodialysis through tunneled/non-tunneled dialysis catheters and arteriovenous fistulas. The greatest disadvantage of the hemodialysis access is  the limited durability of the arteriovenous fistulas and grafts, which, on average, remain patent for <3 years, but are the lifeline for hemodialysis patients. Catheter-directed interventions are successful in re-establishing flow in more than 80% of thrombosed hemodialysis fistulas and have become the treatment of choice for failing or thrombosed accesses. However, these interventions are expensive and require a tertiary center with well-equipped labs. The novel technique of needle-directed thrombolysis is less expensive and can be done on an OPD basis in any primary healthcare setup. To the extent we have searched, no such technique has been published so far in the English literature.

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