Early surgical thrombectomy improves salvage of thrombosed vascular accesses

Sadaghianloo, Nirvana; Jean-Baptiste, Elixène; Gaïd, Hacène; Islam, Mohamed Shariful; Robino, Christophe; Declemy, Serge; Dardik, Alan; Hassen-Khodja, Réda

doi:10.1016/j.jvs.2013.11.092

Cited by 40 publications

(30 citation statements)

References 22 publications

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“…There were four retrospective analyses assessing the effect of time to intervention on outcome of the AV fistula [116][117][118][119]. All were inherently at very high risk of bias through selection, attrition and failing to reach the optimal information size.…”

Section: Rationale • Backgroundmentioning

confidence: 99%

“…A second, retrospective analysis included 59 people with thrombosis of their AV fistula who had all been referred to vascular surgery as quickly as possible [117]. Surgical thrombectomy with percutaneous transluminal angioplasty or stent placement resulted in technically successful declotting of the AV fistula in 84% of participants treated within 6 h of diagnosis.…”

Section: Rationale • Backgroundmentioning

confidence: 99%

See 1 more Smart Citation

Clinical practice guideline on peri- and postoperative care of arteriovenous fistulas and grafts for haemodialysis in adults

Gallieni

Hollenbeck

Inston

et al. 2019

Nephrology Dialysis Transplantation

105

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Chapter 2. Surgical and endovascular interventions for promoting arteriovenous fistula maturation 2.1. We suggest using regional block anaesthesia rather than local anaesthesia for arteriovenous fistula creation in adults with end-stage kidney disease. (2C) 2.2. We suggest there is insufficient evidence to support endof-vein to side-of-artery over side-of-vein to side-ofartery anastomosis for arteriovenous fistula creation in adults with end-stage kidney disease (2C) peri-and postoperative care of AV fistulas and grafts ii3

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Section: Rationale • Backgroundmentioning

confidence: 99%

Section: Rationale • Backgroundmentioning

confidence: 99%

Clinical practice guideline on peri- and postoperative care of arteriovenous fistulas and grafts for haemodialysis in adults

Gallieni

Hollenbeck

Inston

et al. 2019

Nephrology Dialysis Transplantation

105

View full text Add to dashboard Cite

show abstract

“…A concomitant central vein stenosis was present in three patients that required additional venoplasty before graft declotting occurred. Three patients required majority of the patients from the insertion of a temporary vascular catheter for interim dialysis (and their associated morbidity and costs), early thrombectomy has been shown to have better outcomes in the form of higher technical success and potentially midterm patency rates (16). The National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines on the management of thrombosed AVGs recommends a clinical success rate of 85% after thrombectomy (17).…”

Section: Procedural Resultsmentioning

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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“…The use of such devices in these situations, particularly as opposed to other interventional options such as use of multiple repeat angioplasties; drugeluting balloons; cutting balloons; new surgical options (e.g., creation of new access sites); or placement of long-term catheters for definitive access for dialysis, is a open for debate. [2][3][4][5][6][7][8][9][10][11][12][13][14] Opponents of the early use of stent grafts describe the lack of long-term outcome data, the cost of such devices, and the nonsustained benefit (>6 months) described in much of the literature as reasons against the early use of these devices. Proponents of early stent graft use counter with the argument that stent grafts provide early (6 months) benefit when compared with PTA alone, may provide added benefit when used in thrombosed grafts, and as described in these three cases may be used in salvage situations.…”

Section: Discussionmentioning

confidence: 99%

Advanced Stent Graft Treatment of Venous Stenosis Affecting Hemodialysis Vascular Access: Case Illustrations

Patel

Ray

Lokken

et al. 2016

Semin intervent Radiol

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Surgically placed dialysis access is an important component of dialysis replacement therapy. The vast majority of patients undergoing dialysis will have surgically placed accesses at some point in the course of their disease, and for many patients these accesses may represent their definitive renal replacement option. Most, if not all, arteriovenous fistulae and grafts will require interventions at some point in time. Percutaneous angioplasty is the typical first treatment performed for venous stenoses, with stents and stent grafts being reserved for patients in whom angioplasty and surgical options are exhausted. In some salvage situations, stent graft placement may be the only or best option for patients. This article describes, using case illustrations, placement of stent grafts in such patients; a focus will also be made on the techniques utilized in such salvage situations.

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Early surgical thrombectomy improves salvage of thrombosed vascular accesses

Abstract: After acute access thrombosis, early surgical thrombectomy was associated with higher technical success and potentially improved midterm patency.

Cited by 40 publications

References 22 publications

Clinical practice guideline on peri- and postoperative care of arteriovenous fistulas and grafts for haemodialysis in adults

Clinical practice guideline on peri- and postoperative care of arteriovenous fistulas and grafts for haemodialysis in adults

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

Advanced Stent Graft Treatment of Venous Stenosis Affecting Hemodialysis Vascular Access: Case Illustrations

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