A metaanalysis comparing surgical thrombectomy, mechanical thrombectomy, and pharmacomechanical thrombolysis for thrombosed dialysis grafts

Abstract

The analysis of all currently available randomized controlled trials clearly supports the use of surgical thrombectomy for the treatment of thrombosed prosthetic vascular access grafts. The use of endovascular techniques has been found to be inferior to surgery in terms of both primary patency and technical failure rates.

Effect of the time to intervention on the outcome of thrombosed dialysis access grafts managed percutaneously

“…Percutaneous endovascular techniques have proven to be successful with the added benefits of lower cost and periprocedural morbidity when compared to surgical thrombectomy (3,11). Studies have shown that surveillance of indwelling arteriovenous (AV) grafts can reduce the number of thromboses, and that procedure technique can influence success (11,12,(22)(23)(24). Allon et al (23) reported dramatic improvement in the maintenance of AV grafts in their dialysis population on implementation of a multidisciplinary approach that involved the transition of procedures to an outpatient setting, aggressive surveillance, and detailed logistical support.…”

Midterm Results Following Percutaneous Rotational Thrombectomy for Acute Thrombotic Occlusions of Prosthetic Arteriovenous Access Grafts

“…12,13 Studies have shown that surveillance of indwelling AV grafts can reduce the number of thromboses, and that this procedure technique can influence success. 12,14 Today, modern endovascular thrombectomy devices that use different methods of thrombus fragmentation and transportation are commercially available. Some of these devices use the vortex principle to fragment the thrombus (e.g., the Amplatz and the AngioJet thrombectomy catheters), or the Venturi effect (e.g., the Hydrolyser thrombectomy catheter).…”

“…11 When taking into account the lower invasiveness of percutaneous thrombectomies, we can assume their important role in the treatment of such patients. 12 Percutaneous endovascular techniques have proven to be successful, with the added benefits of periprocedural morbidity when compared with surgical thrombectomy. 12,13 Studies have shown that surveillance of indwelling AV grafts can reduce the number of thromboses, and that this procedure technique can influence success.…”

“…12 Percutaneous endovascular techniques have proven to be successful, with the added benefits of periprocedural morbidity when compared with surgical thrombectomy. 12,13 Studies have shown that surveillance of indwelling AV grafts can reduce the number of thromboses, and that this procedure technique can influence success. 12,14 Today, modern endovascular thrombectomy devices that use different methods of thrombus fragmentation and transportation are commercially available.…”

New hybrid procedures in treating occluded arteriovenous hemodialysis grafts

“…Confirmed VAG stenosis after thrombectomy using Fogarty catheter. 7,8 . Results of the individual methods in the years 1995-2009 were evaluated by Tordoir who concluded that the outcome of endovascular and surgical intervention for thrombosed vascular access is comparable, in particular for thrombosed prosthetic grafts 5 .…”