篇名 | Endovascular Declotting of Wall-Adherent Thrombi in Hemodialysis Vascular Access |
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卷期 | 30:2 |
作者 | Hung, Chih-wei 、 Lai, Chao-lun 、 Hsieh, Mu-yang 、 Kuo, Ruei-cheng 、 Tsai, Kuei-chin 、 Lin, Lin 、 Wu, Chih-cheng |
頁次 | 128-135 |
關鍵字 | Adherent 、 Angioplasty 、 Endovascular 、 Hemodialysis 、 Thrombectomy 、 Vascular access 、 MEDLINE 、 SCI 、 Scopus |
出刊日期 | 201403 |
Background: To investigate the efficacy, safety, and patency following treatment of wall-adherent thrombus in hemodialysis vascular access with a wall-contact device, the Arrow-Trerotola percutaneous thrombolytic device (PTD).
Methods: We retrospectively reviewed an existing database of procedures fulfilling the following criteria: thrombosed hemodialysis access, wall-adherent thrombus, and use of PTD formechanical thrombectomy. Data on immediate success, complications, and patency were collected from medical records, dialysis records, and angiographic reports.
Results: Ninety-three patients with 108 episodes of vascular access thrombosis were included in the study. Fifty-three of the procedures were performed on native fistulas, and 55 were on synthetic grafts. Anatomical and clinical successwas achieved in 97% and 96% of the procedures, respectively. The average procedure timewas 52 23 minutes. Complications occurred in three of the procedures (2.7%), but none of these complications were device-related. The primary patency rates in the native fistula group were 57% and 42% at three and six months, respectively. The primary patency rates in the synthetic graft group were 40% at three months, and 27% at six months. The secondary patency rates at six months were 91% in the native fistula group, and 93% in the synthetic graft group.
Conclusions: Our results show that a wall-contact mechanical device, PTD, is effective and safe for endovascular removal of wall-adherent thrombi in hemodialysis vascular access in both native fistulas and synthetic grafts.