Thrombectomy and Thrombolysis

Blood clots form for a variety of reasons and disrupt blood flow.  Thrombolysis and thrombectomy are minimally invasive procedures that our vascular surgeons at Surgical Affiliates of NJ  perform to treat and remove a blood clot from your dialysis access.

What are thrombolysis and thrombectomy procedures?

When blood clots develop in a dialysis access the clotting needs to be treated to restore blood flow through the access.

These treatments include :

  • Thrombolysis which involves the use of clot-busting medications which are injected directly into the clot to dissolve it.

  • Thrombectomy utilizes an angioplasty balloon catheter, and perhaps a specialized mechanical device to break up and remove the blood clot from the fistula or graft.

Catheter-directed thrombolysis

Thrombolysis, also known as thrombolytic therapy, is the use of drugs as treatment for the breakdown (lysis) of blood clots that have blocked your dialysis access.  This treatment involves the injection of clot-busting drugs through a catheter to deliver drugs directly to the site of the blockage. The goal of this clot busting procedure is to restore blood flow through your access.

Thrombolysis is a minimally invasive, outpatient procedure performed by a vascular specialist. For the procedure, you will first be given a local anesthetic to numb the area and if needed, a moderate sedative to help you relax.

Then, using X-ray technology to guide a catheter into your clotted access, a clot dissolving medication will be delivered through the catheter directly to the blood clot. Once the medication has been delivered to the affected area it will be left to dwell for a period of time to break up the clot. Removal of the clot from the vessel by thrombolysis is a relatively quick procedure (usually completed in less than one hour).  At the end of the procedure, the catheter used to perform the procedure is removed.

Thrombectomy

A thrombectomy removes the blood clot through a catheter-guided procedure. Our vascular surgeons perform the outpatient procedure to remove the clot from the fistula or graft using an instrument specifically designed to do so, eliminating the need for a more invasive procedure.

For the thrombectomy procedure, a local anesthetic to numb the area first will be administered and if needed, a moderate sedative may be given to help you relax.  An interventional vascular specialist will insert a catheter into your access guided by X-ray technology. The catheter is used to break up and remove the clot. In some cases a specialized instrument will be inserted through the catheter to aid in breaking up an  removing the clot.  The catheter is removed when the clot has been retrieved and the procedure is complete.  This procedure efficiently removes the clot and restores blood flow.

The procedure takes about an hour and no overnight stay is required.

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