How many days after an AVF clots do you determine that attempting a declot procedure is no longer worthwhile?

Fistulas behave differently than grafts. As time goes by, the clot organizes and makes it difficult to pass the wire across the clot in the fistula. The volume of the clot tends to be large in the fistula as well. For these reasons, fistulas need to be declotted asap. I would say that the chance of a successful declot diminishes with time. By 3 days, a percutaneous declot by endovascular techniques may not be possible.

I don't really consider the number of days as much a factor as how many times the fistula has clotted in the last 6-12 months. If clotting is happening more often than every other month on average, then I think it is time to give up on the AV access. I am willing to tolerate 2 declot procedures within a short period of time.

Certainly, I agree it’s best to get them in ASAP. But I don’t have a hard and fast rule about a number of days.

I have successfully declotted AVFs after 3 days. Sadly, when people need to get in ASAP, sometimes they don’t have transportation for several days. I would certainly try on the 4th day or 5th or 6th or 7th.

3-7 Days