Clotted hemodialysis shunts are a frequent and costly complication encountered in end-stage renal patients undergoing hemodialysis. Treatment strategy is rapidly shifting from surgical thrombectomy to percutaneous recanalization because of the ready availability of the latter technique as well as increased patient comfort. We looked at 99 episodes of thrombosis in hemodialysis shunts, 33 in natural fistulae, treated with several percutaneous techniques of recanalization, all with similar and high success rates, regardless of whether thrombolytics were administered or not.