Journal article
Mechanical Thrombectomy in Acute Thrombosis of Dialysis Arteriovenous Fistulae and Grafts Using a Vacuum-Assisted Thrombectomy Catheter: A Multicenter Study.
- Marcelin C Interventional Radiology, Service d'Imagerie Diagnostique et Thérapeutique de l'Adulte, Hôpital Pellegrin, Place Amélie-Raba-Léon, Bordeaux 33076, France. Electronic address: clement.marcelin@gmail.com.
- D'Souza S Endovascular Unit, Royal Preston Hospital, Lancashire University Teaching Health Trust, Preston, United Kingdom.
- Le Bras Y Interventional Radiology, Service d'Imagerie Diagnostique et Thérapeutique de l'Adulte, Hôpital Pellegrin, Place Amélie-Raba-Léon, Bordeaux 33076, France.
- Petitpierre F Interventional Radiology, Service d'Imagerie Diagnostique et Thérapeutique de l'Adulte, Hôpital Pellegrin, Place Amélie-Raba-Léon, Bordeaux 33076, France.
- Grenier N Interventional Radiology, Service d'Imagerie Diagnostique et Thérapeutique de l'Adulte, Hôpital Pellegrin, Place Amélie-Raba-Léon, Bordeaux 33076, France.
- van den Berg JC Interventional Radiology, Centro Vascolare Ticino, Lugano, Inselspital, Universitätsspital Bern Universitätsinstitut für Diagnostische, Interventionelle und Pädiatrische Radiologie, Bern, Switzerland.
- Huasen B Endovascular Unit, Royal Preston Hospital, Lancashire University Teaching Health Trust, Preston, United Kingdom.
- 2018-06-04
Published in:
- Journal of vascular and interventional radiology : JVIR. - 2018
Adult
Aged
Aged, 80 and over
Arteriovenous Shunt, Surgical
Blood Loss, Surgical
Blood Vessel Prosthesis Implantation
Equipment Design
Europe
Female
Graft Occlusion, Vascular
Humans
Male
Middle Aged
Prospective Studies
Renal Dialysis
Risk Factors
Thrombectomy
Thrombosis
Time Factors
Treatment Outcome
Vacuum
Vascular Access Devices
Vascular Patency
English
PURPOSE
To prospectively analyze technical and clinical outcome of percutaneous thrombectomy aspiration using a vacuum-assisted thrombectomy catheter in acutely thrombosed dialysis arteriovenous fistula (AVF) and/or arteriovenous graft (AVG).
MATERIALS AND METHODS
From June 2016 to April 2017, 35 patients (average age, 61.8 y; range, 33-81 y) presenting with acute thrombosis of dialysis AVF and/or AVG were prospectively evaluated for mechanical thrombectomy using the Indigo System. Adjunctive therapies and procedure-related complications were noted. Technical success, clinical success, primary patency, primary assisted patency, and secondary patency of the dialysis fistula were assessed.
RESULTS
Mean follow-up time was 8.5 months (range, 3-12 months). Technical success was 97.1% (34/35 patients). Clinical success was 91.4% (32/35 patients). Complications included hematoma (n = 1), thrombosis < 24 hours (n = 1), and perforation (n = 1). Other mechanical/aspiration thrombectomy devices were used in 1 site to clear the thrombus burden (Arrow-Trerotola [2.8%; 1/35 patients] and Fogarty [5.7%; 2/35 patients]). Average procedure time was 38.1 minutes (range, 15-140 min). Average blood loss during the procedure was 122.5 mL (range, 50-300 mL). The 6-month primary patency, primary assisted patency, and secondary patency were 71%, 80%, and 88.5%. No risk factors for early dialysis fistula occlusion were identified. There was no 30-day mortality.
CONCLUSIONS
Percutaneous mechanical thrombectomy aspiration of thrombosed dialysis AVF and/or AVG with a vacuum-assisted thrombectomy catheter is a safe procedure with a low complication rate and effective method for restoring patency before hemodialysis.
To prospectively analyze technical and clinical outcome of percutaneous thrombectomy aspiration using a vacuum-assisted thrombectomy catheter in acutely thrombosed dialysis arteriovenous fistula (AVF) and/or arteriovenous graft (AVG).
MATERIALS AND METHODS
From June 2016 to April 2017, 35 patients (average age, 61.8 y; range, 33-81 y) presenting with acute thrombosis of dialysis AVF and/or AVG were prospectively evaluated for mechanical thrombectomy using the Indigo System. Adjunctive therapies and procedure-related complications were noted. Technical success, clinical success, primary patency, primary assisted patency, and secondary patency of the dialysis fistula were assessed.
RESULTS
Mean follow-up time was 8.5 months (range, 3-12 months). Technical success was 97.1% (34/35 patients). Clinical success was 91.4% (32/35 patients). Complications included hematoma (n = 1), thrombosis < 24 hours (n = 1), and perforation (n = 1). Other mechanical/aspiration thrombectomy devices were used in 1 site to clear the thrombus burden (Arrow-Trerotola [2.8%; 1/35 patients] and Fogarty [5.7%; 2/35 patients]). Average procedure time was 38.1 minutes (range, 15-140 min). Average blood loss during the procedure was 122.5 mL (range, 50-300 mL). The 6-month primary patency, primary assisted patency, and secondary patency were 71%, 80%, and 88.5%. No risk factors for early dialysis fistula occlusion were identified. There was no 30-day mortality.
CONCLUSIONS
Percutaneous mechanical thrombectomy aspiration of thrombosed dialysis AVF and/or AVG with a vacuum-assisted thrombectomy catheter is a safe procedure with a low complication rate and effective method for restoring patency before hemodialysis.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jvir.2018.02.030
- PMID 29859664
- Persistent URL
- https://folia.unifr.ch/global/documents/178638
Statistics
Document views: 45
File downloads: