Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with sudden loss of thrill and audible bruit in the AVF. Reports no recent trauma or hypotension. History of progressive access dysfunction, including prolonged bleeding post-dialysis and elevated venous pressures during recent sessions. No signs of infection or hematoma.
Clinical Examination Findings
AVF site inspection reveals no erythema, warmth, or purulent drainage. Palpation confirms absence of thrill. Auscultation confirms absence of bruit. Distal pulses are intact. No signs of limb edema or venous congestion.
Treatment Protocol
Immediate referral to Interventional Radiology or Vascular Surgery for urgent thrombectomy/thrombolysis. Initiate systemic anticoagulation if not contraindicated. Schedule urgent dialysis via temporary central venous catheter (CVC) to prevent uremic complications.