Declotting of an Access (Thrombectomy)
There are times when your dialysis access may clot. This can occur in both grafts and fistulas. This may happen to no fault of your own.
Early removal of these clots is very important with regards to avoiding missed dialysis treatments and placement of a catheter. As well, the quicker you are referred and treated for the removal of the clot the more likely the procedure will be successful. For this reason, you should assess your access daily and notify your dialysis center of any changes.
A Declot can be performed by inserting a small balloon into the clotted access and pulling the clot our with the inflated balloon through a small straw (called a sheath). There is no cutting involved. It is all done through the IV sheath. Declot procedures often require the use of blood thinners, heparin and or TPA. These prevent your access from clotting again during the procedure and help to dissolve the clot. Occasionally, other devices may be required to help dissolve and remove the clot. You will also receive medication to make your comfortable during the procedure. After the removal of the clot, you will have an angioplasty procedure to repair the areas of the narrowing that may have led to the clotting of the access.
It is more likely that we will be able to remedy the narrowing in your access or veins and arteries if we treat them before the access clots. That is why it is important to check your access daily and be aware of the “warning signs” that your access may give you to indicating malfunction.
Despite our best efforts, some clotted accesses will not be able to be repaired. In these circumstances, a temporary hemodialysis catheter may need to be placed so dialysis can be continued. Your surgeon will be contacted so a new access or revision can be planned.
If at any time, you have questions about your procedure or dialysis access contact us our Southfield or Rochester access centers directly or contact your kidney specialist.