Comparisons of clinical outcomes for thrombectomy devices with different mechanisms in hemodialysis arteriovenous fistulas

Yang, Chung-May; Yang, Chung-Wei; Wen, Szu-Chi; Wu, Chih‐Cheng

doi:10.1002/ccd.24408

Cited by 36 publications

(60 citation statements)

References 24 publications

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“…The primary patency rates after 6 months were 45 % with the use of the angio-jet and 43 % after PTD. The secondary patency rates after a year were 74 % and 87 %, respectively [76]. In total, the treatment of the underlying stenosis determines the long-term success of thrombectomy or thrombolysis.…”

Section: Thrombosed Av Fistulamentioning

confidence: 99%

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Kamper

Faizy²,

Haage³

2015

Fortschr Röntgenstr

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A wide variety of diagnostic and minimally invasive modalities is currently available to radiologists for providing sufficient medical care for dialysis patients. In addition to clinical examination, ultrasound is the first line imaging method in suspected dialysis vascular access dysfunction. The percutaneous approach is the primarily recommended therapeutic option in many cases. This article reviews the current diagnostic and therapeutic methods in dialysis vascular access insufficiency. Key Points: ??Vascular access dysfunction is often elicited by stenosed vessels, which are regularly associated with concomitant thrombosis. ??Stenoses are commonly observed in the anastomosis, vascular access vein and also in the central venous system. ??Beside the clinical examination, sonography is the diagnostic method of first choice. ??Percutaneous balloon dilatation frequently is the first treatment option. Citation Format: ??Kamper L, Faizy TD, Haage P. Diagnosis and Treatment of Insufficient Dialysis Vascular Access. Fortschr R?ntgenstr 2015; 187: 360???371

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Section: Thrombosed Av Fistulamentioning

confidence: 99%

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Kamper

Faizy²,

Haage³

2015

Fortschr Röntgenstr

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“…The outcomes might be hampered by the use of an older AngioJet™ system with lower power and lacking a standardized treatment protocol and expertise. More recent studies, including ours, were conducted with the newer, more powerful, AngioJet™ AVX system and show improved results, reporting clinical success rates of up to 97% …”

Section: Discussionmentioning

confidence: 85%

“…Only two patients in each group did not receive adjuvant periprocedural interventions. It has also been suggested that long‐term patency is dependent on effective treatment of underlying stenosis and not on the thrombectomy technique …”

Section: Discussionmentioning

confidence: 99%

“…Endovascular mechanical thrombectomy using the AngioJet™ Peripheral Thrombectomy system (Boston Scientific, Natick, MA) can be deemed an effective technique, as described in a large multicenter registry for treatment of deep vein thrombosis . Experience with this system in occluded vascular access is relatively limited though, especially in native AVF, with varying clinical success and patency rates . Moreover, the quality of the evidence fluctuates …”

Section: Introductionmentioning

confidence: 99%

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Outcomes after endovascular mechanical thrombectomy in occluded vascular access used for dialysis purposes

Drouven

Bruin

Roon

et al. 2020

Cathet Cardio Intervent

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Purpose Endovascular mechanical thrombectomy using the AngioJet™ system can be considered to reestablish patency in occluded vascular access. The aim of this study was to review our results for endovascular mechanical thrombectomy using the AngioJet™ system in patients with arteriovenous fistulae (AVF) and arteriovenous grafts (AVG). Methods Data collected in a database of patients requiring hemodialysis for renal failure were analyzed. Patients who underwent endovascular mechanical thrombectomy procedures with the AngioJet™ system for occlusion of vascular access were included. Clinical and technical success rates and patency rates were calculated. Multivariate analysis was used to identify factors of influence. Results A total of 92 AngioJet™ procedures in 60 patients with thrombosed vascular access were reviewed during a mean follow‐up period of 21.5 months in patients with an AVF and 11.9 months in patients with an AVG. Technical and clinical success was achieved in 92.6% of AVF cases and 92.0 and 90.8% of AVG cases with an AVG, respectively. Significantly higher primary and primary‐assisted patency rates were observed in the AVF group. Multivariate regression analysis indicated that left‐sided vascular access and female sex were independent predictors for failure regarding primary patency in AVG patients. Immunosuppressive drugs and older age were negative predictors for secondary patency in AVG patients. Conclusions The AngioJet™ system can be deemed an effective technique to reestablish patency in occluded vascular access with minimal use of central venous catheters for dialysis. Good technical and clinical success rates were achieved with acceptable patency rates, especially in AVF patients.

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“…The technical and clinical success rates of the various percutaneous declotting techniques range from 75% to 95% in the contemporary literature (14,15). Performing the declotting procedure completely percutaneously has several benefits.…”

Section: Discussionmentioning

confidence: 99%

Novel use of the ClariVein® Catheter for Pharmacomechanical Thrombolysis of Thrombosed Hemodialysis Grafts: A Case Series

Lim

Chen

et al. 2017

J Vasc Access

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Introduction The aim of this prospectively collected case series is to demonstrate a novel technique of using the ClariVein® catheter for pharmacomechanical thrombolysis of thrombosed hemodialysis grafts. Methods The analysis comprised 11 procedures in 9 patients from 1 July to 31 December 2016 in which the ClariVein catheter was used in combination with urokinase. Demographic data, procedural data, technical and clinical success rates, and complications were evaluated. The primary and secondary patency rates at 1 and 3 months were also analyzed. Results In the 11 procedures performed, the technical and clinical success was 100%. The mean procedural time was 66.8 minutes (range 50-90 minutes), and the mean amount of urokinase administered was 87,000 units. The primary unassisted patency rates at 1 and 3 months were 81.8% and 63.6%, respectively. The secondary patency rates at 1 and 3 months were 90.9% and 81.8%, respectively. Perforation occurred after balloon angioplasty in 1 (9.1%) of the 11 procedures, for which covered stenting was performed. No major complications occurred. Conclusions The combination use of the ClariVein catheter with urokinase for pharmacomechanical thrombolysis in thrombosed hemodialysis grafts is a feasible and safe method that can be performed in a relatively short duration. Our early results have shown 100% technical and clinical success. This case series serves as a platform for an upcoming prospective study to further evaluate this method.

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Comparisons of clinical outcomes for thrombectomy devices with different mechanisms in hemodialysis arteriovenous fistulas

Abstract: For the salvage of thrombosed AV fistulas, a device using rotational mechanism is more time-saving with a higher immediate success rate and secondary patency rate. However, the long-term patency results were not different.

Cited by 36 publications

References 24 publications

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Outcomes after endovascular mechanical thrombectomy in occluded vascular access used for dialysis purposes

Novel use of the ClariVein® Catheter for Pharmacomechanical Thrombolysis of Thrombosed Hemodialysis Grafts: A Case Series

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