Non-traumatic vascular emergencies: management of occluded hemodialysis shunts and venous access.

Shunt thrombosis is a relatively frequent complication of implant grafts but less common in native fistulas; both may undergo mechanical recanalization without thrombolysis. While in native fistulas, simple balloon angioplasty is a very useful tool for short-segment thrombosis, extensive thrombosis in native veins or grafts requires use of different mechanical devices or aspiration catheters. In venous access thrombosis, thrombolysis or fibrinous sheath stripping are percutaneous options.