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CC BY-NC-ND 4.0 · Thromb Haemost
DOI: 10.1055/a-2772-5837
Original Article: Coagulation and Fibrinolysis

Characterization of Arteriovenous Thrombus Formation and Propagation in a Mouse Arteriovenous Fistula Model

Autor*innen

  • Hualong Bai‡   ‡

    1   Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States

  • Zhuo Li‡   ‡

    1   Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States

  • Bryan Ho

    1   Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States
    2   Department of Surgery, Yale School of Medicine, New Haven, Connecticut, United States

  • Yujun Cai

    2   Department of Surgery, Yale School of Medicine, New Haven, Connecticut, United States

  • John Hwa

    3   Section of Cardiovascular Medicine and Yale Cooperative Center of Excellence in Hematology, Department of Internal Medicine, Yale Cardiovascular Research Center, Yale University School of Medicine, New Haven, Connecticut, United States

  • Alan Dardik

    1   Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States
    2   Department of Surgery, Yale School of Medicine, New Haven, Connecticut, United States

Funding Information This work was supported by the US National Institutes of Health grants R01-HL 162580 (to A.D.) and R01-HL144476 (to A.D.). Bryan B. Ho was funded by the US National Institutes of Health T32 training grant 2T32GM086287–16.
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Graphical Abstract

Abstract

Background

Compared with an arterial thrombus (AT) or a venous thrombus (VT), there is limited knowledge about arteriovenous thrombus (AVT). AVT develops in 69% of arteriovenous fistulae (AVF) and 50% of arteriovenous grafts (AVG) within 1 year. Thrombosis remains one of the major complications after creation of a vascular access often resulting in failure of the access.

Objective

To characterize and differentiate AVT from VT or AT.

Methods

An AVT model was established by a needle puncture through the aorta to the inferior vena cava (IVC) in wild type mice and different reporter mice and compared with a mouse venous thrombus (VT) model using IVC ligation. AVT was also examined under defined arteriovenous flow conditions. AVT was examined by gross view, histology, immunofluorescence, and scanning electron microscopy.

Results

AVT occurs immediately at the juxta-anastomotic area (JAA) after successful arteriovenous flow was established, with platelets being a major component of early AVT. Reduced injury to the endothelium resulted in smaller AVT, whereas local delivery of rapamycin to inhibit cell proliferation failed to decrease the volume of the AVT. Incomplete reendothelialization of the peri-fistula exit area correlated with growth of the AVT. AVT universally presents at the JAA in other arteriovenous models.

Conclusion

We provide the first detailed histopathological characterization of AVT induced by AVF. AVT originates from the injured vessel wall and is more similar to AT than VT. This model provides a valuable tool to characterize AVT. Both this AVT model and our data have potential for clinical translation.

Keywords

arteriovenous thrombus - arteriovenous flow - neointimal hyperplasia - juxta-anastomosis stenosis

Data Availability Statement

The authors confirm that the data supporting the results of this study are available in the article. If required, further information can be obtained on request from the corresponding author Dr. Alan Dardik (alan.dardik@mountsinai.org). The authors will share more detailed information about any of the animal models or analytical procedures with anyone who wishes to use these models or procedures in their research.


‡ These authors contributed equally to this article.


Supplementary Material



Publikationsverlauf

Eingereicht: 25. September 2025

Angenommen nach Revision: 14. Dezember 2025

Accepted Manuscript online:
16. Dezember 2025

Artikel online veröffentlicht:
31. Dezember 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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