Abstract: Objective  This study aims to evaluate the efficacy and long-term patency rate of thrombosis in artificial vascular arteriovenous grafts treated with endovascular methods under ultrasound guidance.  Methods  A total of 124 arteriovenous accesses (16 brachio-cephalic, 31 brachio-median, 65 brachio-basilic,10 brachio-brachial and 2 brachio-axillary) were included in the study. All patients were treated with endovascular therapy under ultrasound guidance. Baseline data and surgical information were collected. They were followed up for 12 months to observe the postoperative patency and to analyze the factors affecting the primary patency.  Results The procedural technical success rate was 98.39%. The total complication rate was 1.6%. No symptomatic pulmonary embolism and arterial embolism happened. The primary patency rates for postoperative arteriovenous grafts were 87.9% at 3 months, 74.19% at 6 months, and 62.10% at one year. The assisted primary patency rates for postoperative arteriovenous grafts were 100% at 3 months, 91.13% at 6 months, and 85.48 % at one year. Cox analysis showed that outlet stenosis (95% CI：1.451～4.950, P=0.035), higher low density lipoprotein cholesterol (95% CI：1.507～3.139, P=0.048) and hypoproteinemia (95% CI：1.854～4.295, P=0.043) were the risk factors affecting primary patency after intervention of thrombus in arteriovenous grafts.  Conclusion  Ultrasound-guided endovascular thrombolytic treatment for thrombosis in vascular arteriovenous graft has a high technical success rate and can effectively improve the long-term patency rate of vascular arteriovenous grafts.

Key words: Thrombosis in arteriovenous graft； Patency rate； Endovascular treatment； , Thrombectomy procedure