The major cause of graft failure is thrombosis due to underlying stenosis of the venous anastomosis, draining vein, or central vein [10, 38]. When the stenosis is not detected and corrected in a timely fashion, grafts typically thrombose. Clotted grafts require thrombectomy by either Radiology or Surgery, most commonly in association with correction of the underlying stenosis. If graft patency cannot be restored, it becomes necessary to construct a vascular access at a new anastomotic site. Intervention-free graft patency is considerably lower following thrombectomy than after elective angioplasty [10]. A comparison of graft outcomes after radiologic interventions at our institution found that the primary (unassisted) patency was only 30% at 3 months for clotted grafts, as compared with 71% for patent grafts undergoing elective angioplasty [10]. Not surprisingly, graft survival was worse if there was a residual stenosis after the angioplasty. However, even in the subset of patients with no residual stenosis after the intervention, the primary 3-month patency was still lower in clotted grafts, as compared with patent grafts undergoing elective angioplasty (median survival, 2.5 vs 6.9 months).