Hybrid Therapy Using a Surgical Thrombectomy with a Balloon Angioplasty to Regain Thrombosed Dialysis Vascular Access-Clinical Case Series

Introduction: Thrombectomy is the most common surgical method used to re-establish thrombosed vascular access, particularly in hemodialysis patients.To achieve better patient outcomes and to improve the prognosis for surgical thrombectomy, fistulography with balloon angioplasty to assist during surgery has been introduced in recent years.Methods: In this study, the results of hybrid therapy in 53 patients with thrombosed vascular access were examined.The success rate for re-opening vascular access and dialysis success were recorded, immediately, and at 1 m and 6 m after the surgical procedure.Results: Of 53 patients, 40 patients underwent balloon angioplasty.The success rate in the first session of dialysis after surgery was 85%.At 1 m and 6 m, the dialysis success rates were 75% and 55%, respectively. Conclusion:The use of hybrid method to re-establish vascular access in hemodialysis patients was not only quite effective but also showed several advantages over other conventional methods.Using this method, possible thrombotic lesions were evaluated and corrected with balloon angioplasty.In addition to reducing the risk of recurrent path failure, all these procedures can be performed during one session in the operating room, which led to reductions in surgical and recovery time and costs for both the surgeons and the patients.