Topic: Considerations in Salvaging Thrombosed Arteriovenous Fistulae

Abstract

The number of haemodialysis patients in Malaysia have been increasing exponentially over the last 10 year with 167 per million population(pmp) in 2008 to 260 pmp in 2018. This is contrast in to the number of transplants which have decreased from 5 pmp in 2008 to 3 pmp in 2018. As such, most fistulas will need to last the lifetime of the patient. Thus, a thrombosed fistula has serious consequences to the patient in the aspects of morbidity, mortality and also financial.

Considerations need to be given to which fistula that can be salvaged and this includes the type of fistula ie radiocephalic, brachiocephalic or brachiobasilic. Other factors include the presence of aneurysms as the thrombus load is often high in those patients. Other important considerations including the duration of thrombosis and also the expertise and facilities available.

The various factors will be discussed in this very dire complication of the ‘life line’ of ESRD patients.