Objective. To develop an algorithm for choosing surgical tactics in hemodialysis access thrombosis. Subjects and methods. The results of a surgical intervention were retrospectively analyzed in 60 patients with chronic kidney disease who were treated with hemodialysis for dialysis access thrombosis. Surgical options were performed in patients with dialysis access thrombosis: surgical thrombectomy (thrombotic mass extraction using a No. 6 Fogarty balloon catheter); proximal reanastomosis; excision of the stenotic portion of the vein or bridging plasty (implantation of the relevant portion of a synthetic vascular graft). Results. The relationship was established between the surgical volume to achieve anatomic, procedural, and hemodynamic successes and the calculated parameter DF (the phenomenological detection of a hemodynamically significant stenotic process in dialysis access [Yu.I. Shakhrai et al., 2014; Invention Patent № 2508544]. Taking into account the role of hemodynamically significant stenosis in both developing access thrombotic events and determining its nature in the outcome of various surgical correction procedures, the diagnosis of this event is critical, as the surgical volume directly affects the possibility and timing of incorporating the reconstructed access into the hemodialysis process and makes it possible to approximate a 100% success of rehabilitation of an arteriovenous fistula or a synthetic vascular graft. Conclusion. Surgical thrombectomy using a Fogarty balloon catheter as an independent technique was effective in the absence of a hemodynamically significant stenotic process (the negative DF value determined phenomenologically). In hemodynamically significant stenosis (a positive DF value), the adequate surgical option is proximal reanastomosis; bridging plasty.