#5245 SUCCESSFUL THROMBOLYSIS OF AN ATRIAL TUNNELED DIALYSIS CATHETER AS A LAST RESORT VASCULAR ACCESS

Abstract Background and Aims The prolonged survival of patients on dialysis has resulted in a higher frequency complications failure related to vascular access. As result, the situation depleted vasculature hemodialysis is becoming increasingly prevalent. use an atrial tunneled catheter (ATDC) been reported as effective solution for access these patients, but limited data available associated complications, particularly thrombosis. Method This study reports experience single nephrology center Tunis with thrombosis ATDC last resort dialysis. Results A 32-year-old patient undetermined tubulo-interstitial nephropathy receiving presented November 2022 vasculature. An was inserted final access, initial complication catheter-related bloodstream infection, which resolved broad-spectrum antibiotics favorable results. One month later, could not be initiated through ATDC. Catheter diagnosed guidewire unable pass catheter's lumen. successfully treated thrombolysis using 50 mg Alteplase, allowing resumed blood flow 300 mL/min. Conclusion lifesaving safe option vasculature, only 51 cases since 1999 [1]. treatment well defined, best our knowledge, no protocol established. successful case may contribute filling knowledge gap this field.