Abstract: 【Abstract】Objective This is a comparative analysis to investigate Alteplase (rt-PA) and Reteplase (r-PA) for thrombolysis treatment in arteriovenous fistula (AVF). Methods A total of 132 patients with the blockage of AVF due to thrombosis and treated in the hospital from January 2015 to February 2018 were recruited in this study. They were assigned into two groups based on the hospitalization day: r-PA group (n=105, treated with r-PA), and rt-PA group (n=27, treated with rt-PA). The re-patency rate, re-patency time and adverse events in the two groups were observed after the treatment. Result There were no significant differences in age, risk factors and the time of thrombolysis treatment between the two groups (P>0.05). The re-patency rate was 81.48% (22/27cases) in rt-PA group, and 78.1% (82/105cases) in r-PA group (χ2=0.147, P=0.701). The re-patency time was longer in rt-PA group than in r-PA group [3.75 (1.75～4.88) vs. 1.50 (1.50～3.23), Z=- 2.135, P=0.033]. Fibrinogen decreased in both groups. The decrease of fibrinogen was within normal range in both groups, but was more in r-PA group than in rt-PA group (1.92±0.88 g/L vs. 2.73±0.88, t=-5.331, P＜0.001]. Patients with minor bleeding were 2/27 in rt-PA group and were 17/105 in r-PA group (χ2=0.726, P=0.394). No bleeding in brain, gastrointestinal tract and any other organs were found in both groups. Conclusion r-PA and rt-PA have similar effect on thrombolysis in AVF. rt-PA has less influence on coagulation and bleeding.

Key words: Reteplase, Alteplase, Arteriovenous fistula, Thrombolytic therapy, Dialysis