Disconnection of the Rubber Tip of Arrow-Trerotola Percutaneous Thrombolytic Device

Kim, Han Myun; Kim, Hyo Cheol; Woo, Sungmin; Son, Kuk Hui; Jae, Hwan Jun

doi:10.3348/kjr.2014.15.2.254

Cited by 5 publications

(3 citation statements)

References 10 publications

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“…A case series from Kim et al in 2014 reported five instances of disconnection in 453 uses of the device. 12 The disconnections occurred both in fistulae and grafts, and the apparent commonality of each case was activation of the device across a segment of the fistula or graft with an acute angulation. The likely mechanism is fixation of the soft rubber tip during rapid (3,000 rpm) rotation of the fragmentation basket, which then becomes disconnected secondary to material fatigue.…”

Section: Discussionmentioning

confidence: 99%

Managing Arrow-Trerotola Percutaneous Thrombolytic Device Complications

Simpson

Gaba

Lipnik

2019

Semin intervent Radiol

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Dialysis access interventions are frequently performed by interventional radiologists. Several commercially available percutaneous thrombolytic devices can help restore patency to thrombosed arteriovenous access circuits. The Arrow-Trerotola Percutaneous Thrombolytic Device is one such device, and has a long track record of safe and effective use. However, like any medical device, complications can occur during its use. This article describes three complications and associated management strategies utilizing fundamental interventional radiology techniques of balloon tamponade, stent placement, and snare mediated foreign body retrieval.

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Section: Discussionmentioning

confidence: 99%

Managing Arrow-Trerotola Percutaneous Thrombolytic Device Complications

Simpson

Gaba

Lipnik

2019

Semin intervent Radiol

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“…According to a previous report, rubber-tip disconnection and fragmentation of the rotatory basket were reported during thrombectomy with a rotational PTD device. 36,37 These events occurred in an angulated vessel or indwelling stent or aneurysmal segment. Therefore, careful use of the PTD is recommended in such situations to avoid complications.…”

Section: Discussionmentioning

confidence: 99%

Thrombosed native hemodialysis fistulas: Technical and clinical outcomes of endovascular recanalization and factors influencing patency

Choi

et al. 2019

J Vasc Access

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Purpose: To evaluate the technical and clinical results of endovascular recanalization of thrombosed native hemodialysis fistula and the factors influencing patency. Methods: A retrospective study was conducted with 73 patients who had thrombosed arteriovenous fistulas and were treated with endovascular methods. Patient characteristics, arteriovenous fistula-related characteristics, and endovascular procedures were analyzed. Technical and clinical results and patency rates were evaluated. The factors influencing patency were analyzed using a univariate and multivariate Cox proportional hazards model. Results: Technical and clinical success rates were 93% (68/73) and 85% (62/73), respectively. At 3, 6, and 12 months, the primary patency rates were 87.9%, 73.3%, and 64.8%; assisted primary patency rates were 89.2%, 78.6%, and 70.7%; and secondary patency rates were 90.8%, 87.2%, and 83.1%, respectively. Previous intervention and cephalic arch stenosis were risk factors for lower primary and assisted primary patency ( p < 0.05 for all). Cephalic arch stenosis was the only risk factor for lower secondary patency ( p < 0.05). No major complications associated with the procedures were noticed. Conclusion: Endovascular treatment was effective for the immediate recanalization of thrombosed arteriovenous fistula. In addition, previous intervention and cephalic arch stenosis were significantly related to lower arteriovenous fistula patency.

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“…Five cases of a rubber tip disconnection were reported among 453 thrombectomies. Those authors experienced a disconnected rubber tip when they activated a PTD within an acute angulated vessel or an indwelled stent ( 26 ). Therefore, careful use of a PTD is highly recommended because there can be complications during thrombectomy and reuse of the device is not recommended.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Recanalization of a Thrombosed Native Arteriovenous Fistula Complicated with an Aneurysm: Technical Aspects and Outcomes

Ahn

Choi

et al. 2015

Korean J Radiol

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ObjectiveTo evaluate the technical aspects and outcomes of endovascular recanalization of a thrombosed native arteriovenous fistula (AVF) complicated with an aneurysm.Materials and MethodsSixteen patients who had a thrombosed AVF complicated with an aneurysm (two radiocephalic and 14 brachiocephalic) were included in this study. Recanalization procedures were performed by mechanical thrombectomy using the Arrow-Trerotola percutaneous thrombectomy device and adjunctive treatments. We evaluated dose of thrombolytic agent, underlying stenosis, procedure time, technical and clinical success, and complications. The primary and secondary patency rates were calculated using the Kaplan-Meier analysis.ResultsThe thrombolytic agents used were 100000 U urokinase mixed with 500 IU heparin (n = 10) or a double dose of the mixture (n = 6). The thrombi in aneurysms were removed in all but two patients with non-flow limiting residual thrombi. One recanalization failure occurred due to a device failure. Aspiration thrombectomy was performed in 87.5% of cases (n = 14). Underlying stenoses were found in the outflow draining vein (n = 16), arteriovenous anastomosis or juxtaanastomosis area (n = 5), and the central vein (n = 3). Balloon angioplasty was performed for all stenoses in 15 patients. Two patients with a symptomatic central vein stenosis underwent insertion of a stent after balloon angioplasty. Mean procedure time was 116.3 minutes. Minor extravasation (n = 1) was resolved by manual compression. Both technical and clinical success rates were 93.8% (n = 15). The primary patency rates at 3, 6, and 12 months were 70.5%, 54.8%, and 31.3%, respectively. The secondary patency rates at 3, 6, and 12 months were 70.5%, 70.5%, and 47.0%, respectively.ConclusionThrombosed AVF complicated with an aneurysm can be successfully recanalized, and secondary patency can be prolonged with endovascular treatment.

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Disconnection of the Rubber Tip of Arrow-Trerotola Percutaneous Thrombolytic Device

Cited by 5 publications

References 10 publications

Managing Arrow-Trerotola Percutaneous Thrombolytic Device Complications

Managing Arrow-Trerotola Percutaneous Thrombolytic Device Complications

Thrombosed native hemodialysis fistulas: Technical and clinical outcomes of endovascular recanalization and factors influencing patency

Endovascular Recanalization of a Thrombosed Native Arteriovenous Fistula Complicated with an Aneurysm: Technical Aspects and Outcomes

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