Study of thrombus from thrombosed hemodialysis access grafts

Todd A. Winkler, Scott O. Trerotola, Darrell D. Davidson, Martin L. Milgrom

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58 Scopus citations

Abstract

PURPOSE: To determine the volume and composition of clot within thrombosed hemodialysis access grafts. MATERIALS AND METHODS: Clots were collected in 22 patients at surgical thrombectomy of polytetrafluoroethylene grafts. Histologic analysis was performed in 10 of these clots plus 21 randomly selected clots from the pathology archives. RESULTS: A small, firm piece of whitish thrombus ('arterial plug') was almost always recovered from the arterial limb of the graft. This plug had a concave surface and ranged from 5 mm to 3 cm in length. The remaining clot was soft, red thrombus. The mean weight of all clots was 3.4 g, and mean volume was 3.2 cm3. Average graft length was 42 cm. Histologically, the arterial plug had a characteristic appearance of densely compacted alternating layers of erythrocytes and fibrin. CONCLUSION: Clot volume in thrombosed dialysis grafts is much less (≃25%) than would be expected if the graft were completely filled with thrombus, a finding of significance to mechanical thrombolytic techniques. Resistance of the arterial plug to pulse-spray thrombolysis is likely due to compaction.

Original languageEnglish (US)
Pages (from-to)461-465
Number of pages5
JournalRadiology
Volume197
Issue number2
DOIs
StatePublished - Nov 1995

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Keywords

  • Dialysis
  • Grafts, stenosis or obstruction
  • Thrombolysis

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Winkler, T. A., Trerotola, S. O., Davidson, D. D., & Milgrom, M. L. (1995). Study of thrombus from thrombosed hemodialysis access grafts. Radiology, 197(2), 461-465. https://doi.org/10.1148/radiology.197.2.7480694