Long-term outcomes following thrombolysis of arteriovenous grafts.

Ben Li, Monica Abdelmasih, Naomi Eisenberg, Charmaine Lok, Graham Roche-Nagle

Abstract readMulticenter Study

In one paragraph

Article in The journal of vascular access, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in

2citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

Evaluation and comparison of patency rate and complications of synthetic arteriovenous grafts in the groin and upper extremities among hemodialysis patients.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2026
Article
Rebuilding vascular access: from the viewpoint of mechanics and materials.Frontiers in bioengineering and biotechnology · 2024
Review

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ben LiDivision of Vascular Surgery, Department of Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-7191-1034

Monica AbdelmasihDivision of Vascular Surgery, Department of Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.

Naomi EisenbergDivision of Vascular Surgery, Department of Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.

Charmaine LokDivision of Nephrology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.ORCID 0000-0001-5365-0064

Graham Roche-NagleDivision of Vascular Surgery, Department of Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThrombolysis for arteriovenous grafts (AVG) yields high technical success rates, however, long-term outcomes are unclear. We conducted a multicenter retrospective cohort study to analyze 5-year patency rates following AVG thrombolysis.

methodsAll patients who underwent AVG thrombolysis between 2005 and 2015 at three academic hospitals were included. Prospectively maintained institutional nephrology and radiology databases were used to record demographic, clinical, and AVG characteristics. The primary outcome was primary patency, defined as AVG access survival without re-intervention including angioplasty ± stent with/without re-thrombolysis. Secondary outcomes were assisted primary patency and cumulative patency, defined as AVG access survival until re-thrombosis requiring re-thrombolysis or abandonment, respectively. Technical success was defined as restoration of flow with <30% residual stenosis. Patients were followed until 2017. Patency rates were assessed using Kaplan-Meier survival analysis and Cox proportional hazards were calculated to determine associations between covariates and patency loss.

resultsSeventy-four patients underwent AVG thrombolysis during the study period with a median follow-up period of 21.4 (IQR 8.3-42.8) months. The average age was 58.6 years with a high rate of comorbidities, including hypertension (82.4%) and diabetes (54.1%). Thrombolysis technical success was 96%. There were 147 re-interventions in 46 patients, of which 98 were re-thrombolysis (mean re-intervention rate of 1.27/patient/year). Primary patency at 1, 3, and 5 years were 43.2%, 20.2%, and 7.7%. Assisted primary patency at 1, 3, and 5 years were 47.5%, 20.2%, and 7.7%. Cumulative patency at 1, 3, and 5 years were 75.0%, 38.8%, and 22.6%. Cox proportional hazards analysis demonstrated no associations between demographic, clinical, and procedural characteristics and patency rates.

conclusionsDespite a high technical success rate, thrombolysis for AVG dysfunction is associated with poor long-term patency. Future studies are needed to determine risk factors for re-thrombosis to identify patients who will benefit from AVG thrombolysis in the long-term.

Indexed as

Arteriovenous Shunt, SurgicalBlood Vessel Prosthesis ImplantationGraft Occlusion, VascularRenal DialysisThrombolytic TherapyVascular PatencyAgedDatabases, FactualFemaleFibrinolytic AgentsHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentRisk FactorsFibrinolytic AgentsArteriovenous graftlong-termoutcomespatencythrombolysis

Identifiers

PMID34796766

DOI10.1177/11297298211027470

PMCPMC11075405

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LicenceCC BY

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.