Two patients on maintenance hemodialysis developed recurrent clotting of an arteriovenous shunt. Anticoagulant therapy was complicated by massive gastrointestinal bleeding. Very small doses of heparin sodium administered into both shunt limbs maintained patency while bleeding ceased.
(JAMA 230:427-430, 1974)
Modai D, Leiba IH, Alkan WJ. Prevention of Arteriovenous Shunt Clotting. JAMA. 1974;230(3):427-430. doi:10.1001/jama.1974.03240030045025