الفهرس 
Principles of access placementOnly 14 pages are availabe for public view
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Abstract
Background: Thrombectomy is the most common surgical technique used to re-establish failed hemodialysis access. Then percutaneous thrombectomy was introduced. To achieve better patient outcomes, hybrid technique with combined open thrombectomy and angioplasty has been introduced in recent years.
Aim of the study: To evaluate the hybrid technique by surgical Fogarty thrombectomy and balloon angioplasty in salvage of acutely failed dialysis access regarding feasibility, early and mid term results.
Patients and methods:This case series prospective study was conducted at Fayoum University Hospital and Cairo University Hospitals between December 2017 and October 2018. It included 20 patients; 12 (60%) males and 8(40%) females with a mean age of 52.9± 15.3 years. All patients had acutely failed hemodialysis access that was subjected to hybrid salvage with combined open thrombectomy and angioplasty. Outcome was evaluated regarding clinical success and 6 months primary patency.
Results: All 20 patients were subjected to hybrid thrombectomy and angioplasty. Type of access included radial cephalic (20%), brachial cephalic (50%), brachial basilic (20%) and brachial axillary graft (10%). Mean age of access was 23.9± 21.1 months and mean interval between access thrombosis and intervention was 8.6±3.4 days. The immediate clinical success rate was 80%. The primary patency rates at 1 m and 6 m were 78.9% and 72.2%, respectively.
Conclusion: hybrid salvage technique using combined open thrombectomy and angioplasty provides acceptable patency by removal of thrombus and correction of associated stenosis of acutely failed hemodialysis access.
Key words: hybrid technique, hemodialysis access, failed, salvage, thrombectomy, angioplasty.