Please select the eligibility criteria that correspond to the clinical trial below.
Title: Stent vs. Angioplasty for Treatment of Thrombosed AV Grfats: Long-Term Outcomes
Brief Summary: Arteriovenous grafts are used as the vascular access in 40-50% of hemodialysis patients. Grafts are prone to recurrent stenosis (narrowing) and thrombosis (clotting). Graft clotting is usually due to a narrowing at the site where the graft joins the vein. The standard treatment is to remove the clot and angioplasty the narrowed area. The long-term outcome is not good, lasting only about 1 month. Placing a stent (a small metallic, PTFE covered, spring) at the narrowed site may keep the graft open longer. Principal investigator's preliminary research data suggest that placing a stent at the stenotic site prolongs graft patency following thrombectomy, as compared to conventional angioplasty.

This is a single-center, randomized clinical trial, in which patients with a clotted graft with underlying stenosis at the venous anastomosis of the graft will be allocated to thrombectomy + angioplasty (control group) or to thrombectomy + stent placement (study group). The primary endpoint will be primary (unassisted) graft patency. The secondary endpoints will be secondary (assisted) graft patency and overall access-related costs.


Options:
A: Inclusion Criteria:

* Established dialysis patient with a recent thrombosed AV graft (less than 48 hours).
* AV grafts can be located at the forearm, upper arm or thigh.
* Either first or second episode of thrombosis of the AV graft.
* Stenotic lesion at the venous anastomosis greater than 50% at time of initial intervention.

Exclusion Criteria:

* Established ESRD patients with a recent thrombosed AV fistula.
* Prior participation in this study.
* Prior Stent placement at the venous anastomosis.
* Inability to restore blood flow after mechanical thrombectomy.
* Stenotic lesion at other venous site (i.e. venous outlet or central vessels)
* Three or more prior mechanical thrombectomies and angioplasties of the same graft.
* Stenotic lesion at the venous anastomosis less than 50%
B: Inclusion Criteria:

* Patients with acute thrombosis (\< 10 days) of native or prosthetic AVF.

Exclusion Criteria:

* Known pulmonary hypertension.
* Severe pulmonary disease.
* Low cardiopulmonary reserve.
* Recent creation of vascular access.
* Known right left shunt.
* Access infection.
* Allergy to iodinated contrast.
* Patients under 18 years old.
C: Inclusion Criteria:

* Hemodialysis patient with a dysfunctional or thrombosed forearm or upper arm prosthetic vascular access graft.
* The target lesion starts less than or equal to 30 mm from the venous anastomosis.
* The target lesion has \> 50% stenosis as measured per protocol.
* The patient has a maximum of one secondary stenosis.

Exclusion Criteria:

* The age of the hemodialysis access graft is less than or equal to 30 days old from the date of the study procedure.
* The patient has undergone an intervention (surgical or percutaneous) of the vascular access circuit less than or equal to 30 days from the date of the study procedure.
* The secondary lesion is an occlusion.
D: Inclusion Criteria:

* Angiographic and clinical diagnosis of dysfunctional dialysis access due to one or more stenotic lesions.
* Patients with AVF or AVG
* Fistula or graft or vessel diameter ranging from 3 mm up to 12 mm

Exclusion Criteria:

* Fistula or graft or vessel diameter \< 3 mm and \> 12 mm
* History of severe allergic reaction to contrast media
* Intolerance to aspirin and/or clopidogrel
* Systemic coagulopathy or hypercoagulation disorders

Answer: A