Post-Thrombectomy Vascular Dynamics in Arteriovenous Fistulas : Inflammatory Cascades, Molecular Interactions, and Therapeutic Implications in Hemodialysis

Overview of Arteriovenous Fistula (AVF) and Its Significance in Hemodialysis:Arteriovenous Fistula (AVF), a surgically created connection between an artery and a vein, serves as a lifeline for patients undergoing hemodialysis.[1] This vascular access method is a crit- ical component in the hemodialysis procedure, facilitating the rapid exchange of blood between the body and the dialysis machine, thereby allowing for the efficient removal of waste products and excess fluid from the blood. The use of AVF is underscored by its lower complication rates and greater longevity compared to other vascular access options, such as arteriovenous grafts and central venous catheters. .From a vascular biology perspective, AVFs exploit the high-pressure arterial system to engen- der increased blood flow through the venous segment, which subsequently experiences adap- tive remodeling, including venous dilatation and arterialization to accommodate the augmented hemodynamic load. The hyperdynamic flow within the AVF is crucial for achieving optimal dial- ysis efficacy, and any perturbations in this flow can significantly compromise the hemodialysis