Abstract

This was a retrospective study that looked at the effectiveness of thrombolytic agents in re-establishing flow in thrombosed Brescia-Cimino shunts for 10 patients on chronic dialysis. The thrombolysis was done in an intensive care setting under monitoring for arrhymias, hypotension and desaturation of blood. Of the ten patients 6 (60%) of them were male and 4 (40%) were famale. The average age of the patients was 53.9 + 5.73 years. Eight (80%) of the patients had internal jugular and 2 (20%) had subclavian central venous lines for the thrombolysis. Eight (80%) of the patients had streptokinase and 2 (20%) had urokinase for the thrombolysis. There was re-established flow in 9 (90%) of the shunts and the mean time for the re-establishment of flow in the A-V shunts was 7.56 + 1.07 hours. Two of the patients who had urokinase had previously been given streptokinase, one of a previous thrombosis of his A-V shunt and the other for myocardinal infarction. The commonest complication during the thrombolysis was bleeding (70%) followed by hypotension (50%) and nausea (40%). The hypotension and bleeding from the central venous lines was more common in the patients who were administered steptokinase.