Objective:To investigate the efficacy of sheath-guided thrombectomy combined with large diameter high-pressure balloon angioplasty in treating arteriovenous graft(AVG)occlusion.Methods:90 patients with AVG occlusion were divided into a con-trol group(n=45)and an observation group(n=45)according to the surgical method.The control group underwent surgical Fogarty catheter thrombectomy combined with small diameter high-pressure balloon angioplasty,while the observation group underwent sheath-guided thrombectomy combined with large diameter high-pressure balloon angioplasty.The flow restoration time,length of hospital stay,treatment costs,technical success rate,clinical success rate,primary patency rates at 3 and 6 months post-treatment,internal fistula blood flow,and complication rates were compared between the two groups.Results:In the observation group,the blood flow restoration time was not statistically different from that in the control group(P＞0.05),with a shorter hospital stay(P＜0.05)and lower treat-ment costs(P＜0.05).The technical success rate and clinical success rate of the observation group were not statistically different from those of the control group(P＞0.05).The initial patency rate at 3 months post-treatment in the observation group was not statistically different from that in the control group(P＞0.05),but the internal fistula blood flow was greater than that in the control group(P＜0.05),the initial patency rate and internal fistula blood flow at 6 months post-treatment were higher than those in the control group(P＜0.05).There was no statistically significant difference in the incidence of vascular rupture between the two groups(P＞0.05),the rates of graft infection and symptomatic pulmonary embolism were lower in the observation group(P＜0.05).Conclu-sion:Sheath-guided thrombectomy combined with large diameter high-pressure balloon angioplasty is relatively more effective in treating AVG occlusion,improving initial patency rates and internal fistula blood flow,reducing graft infection and symptomatic pulmonary em-bolism,and offering lower treatment costs.