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논문분류	춘계학술대회 초록집
제목	Surgical Revision of Arteriovenous Access by a Single Interventional Nephrologist: A One-Year Retrospective Single-Center Study
저자	Sangeon Gwoo
출판정보	2026; 2026(1):
키워드	Arteriovenous access, surgical revision, interventional nephrology, hybrid thrombectomy
초록	Objectives: This retrospective, single-center study evaluated surgical revisions of arteriovenous (AV) accesses performed by a single interventional nephrologist over one year. We aimed to assess the clinical success, safety, and feasibility of independently performing conventional surgical approaches to demonstrate the specialty's expanded role. Methods: We analyzed 36 surgical revision cases, evaluating indications and operative techniques. Interventions included hybrid thrombectomy for AV fistula occlusion, inflow reduction (e.g., banding) for inflow-outflow mismatch and flow insufficiency, and collateral/accessory vein ligation for spasm and venous hypertension. Technical success was defined as completing the surgery and restoring access function without a vascular surgeon's assistance. Results: Among 36 patients, 35 procedures (97.2%) were completed independently without external support. One case (2.8%) required a vascular surgeon due to collateral vessel rupture complicating hemostasis. Clinical success—defined as completing at least three consecutive normal hemodialysis sessions post-intervention—was achieved in all cases (100%) without significant procedure-related complications. These independent procedures effectively resolved complex issues including VA occlusion, volume imbalances, and venous hypertension. Conclusion: Well-trained interventional nephrologists can safely perform conventional AV access surgical revisions, achieving a 97.2% independent technical success rate. While rare bleeding complications may require multidisciplinary support, incorporating open surgical techniques expands the interventional nephrologist's therapeutic armamentarium. This enables timely, comprehensive care for hemodialysis patients and significantly reduces reliance on external surgical referrals.
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