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

Prologo, J. David; Minwell, Gregory; Kent, J.; Pirasteh, Ali; Corn, David

doi:10.5152/dir.2013.13296

Cited by 9 publications

(11 citation statements)

References 25 publications

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“…Thrombolysis, thrombectomy, and balloon angioplasty are commonly used techniques to restore circuit patency and salvage immature fistulae (48)(49)(50). Preferably, early identification and intervention of thrombosed hemodialysis circuits to restore access should be attempted within 24-48 hours when possible (10,51,52). Newly established fistulae, upper arm AVFs, long segment outflow venous stenoses, multiple stenoses or occlusions or being elderly or diabetic is associated with reduced primary patency after angioplasty (53,54).…”

Section: Introductionmentioning

confidence: 99%

Quality Improvement Guidelines for Percutaneous Image-Guided Management of the Thrombosed or Dysfunctional Dialysis Circuit

Dariushnia

Walker

Silberzweig

et al. 2016

Journal of Vascular and Interventional Radiology

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AR = access recirculation, AVF = arteriovenous fistula, AVG = arteriovenous graft, DHIS = distal hypoperfusion ischemia syndrome, KDOQI = Kidney Disease Outcomes Quality Initiative, NKF = National Kidney Foundation, Qa = blood access flow rate PREAMBLE The membership of the Society of Interventional Radiology (SIR) Standards of Practice Committee represents experts in a broad spectrum of interventional procedures from both the private and the academic sectors of medicine. Generally, Standards of Practice Committee members dedicate the vast majority of their professional time to performing interventional procedures; as such, they represent a valid broad expert constituency of the subject matter under consideration for standards production. Technical documents specifying the exact consensus and literature review methodologies as well as the institutional affiliations and professional credentials of the authors of this document are available upon request from SIR, 3975 Fair Ridge Dr, Ste 400 North, Fairfax, VA 22033. METHODOLOGY SIR produces its Standards of Practice documents using the following process. Standards documents of relevance and timeliness are conceptualized by the Standards of Practice Committee members. A recognized expert is identified to serve as the principal author for the standard. Additional authors may be assigned depending on the magnitude of the project. An in-depth literature search is performed using electronic medical literature databases. Then a critical review of peer-reviewed articles is performed with regard to the study methodology, results, and conclusions. The qualitative weight of these articles is assembled into an evidence table, which is used to write the document such that it contains evidence-based data with respect to content, rates, and thresholds. When the evidence of literature is weak, conflicting, or contradictory, consensus for the parameter is reached by a minimum of 12 Standards of Practice Committee members using a Modified Delphi Consensus Method (Appendix A). For purposes of these documents, consensus is defined as 80% Delphi participant agreement on a value or parameter. The draft document is critically reviewed by the Revisions Subcommittee members of the Standards of Practice Committee, either by telephone conference calling or by face-to-face meeting. The finalized draft from the Committee is sent to the SIR membership for further input or criticism during a 30-day comment period. These comments are discussed by the Subcommittee, and appropriate revisions are made to create the finished standards document. Before its publication, the document is endorsed by the SIR Executive Council.

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Section: Introductionmentioning

confidence: 99%

Quality Improvement Guidelines for Percutaneous Image-Guided Management of the Thrombosed or Dysfunctional Dialysis Circuit

Dariushnia

Walker

Silberzweig

et al. 2016

Journal of Vascular and Interventional Radiology

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“…The secondary patency rates were 91.2 % after 6 months, 82.7 % after 12 months, and 68.9 % after 24 months in patients with stent grafts and 86.5 %, 78.8 %, and 66.6 %, respectively, after PTA alone. Graft thromboses should be treated before the next dialysis if possible [81]. Kakisis et al examined the use of nitinol stents in the region of venous anastomosis in patients with thrombosed brachio-axillary vascular access grafts after surgical thrombectomy.…”

Section: Insufficient Dialysis Graftmentioning

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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“…11 In a study conducted in patients with autogenous AVF, patency after the procedure seemed to be related with the age of the fistulas and previous treatments performed, especially stenting of underlying angioplasty-resistant stenoses. 5,11 There are four registries (three perspectives and one retrospective) evaluating the effectiveness of AngioJet in both AVGs and AVFs. Clinical success is similar in all the series (>90%), and post-intervention-assisted primary patency at 1 year comprised between 30% and 64%, with a low complication rate.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, the procedure technique may influence the success of percutaneous treatments, as well as performing them in an outpatient setting. 5,12 To the best of our knowledge, only one study has tried to relate the effect of the time interval between the clinical presentation of thrombosis and subsequent angiographic procedure. During the first 72 h following the clinical presentation of a thrombosed dialysis access graft, Prologo et al 5 have found that the time to intervention may be considered independent of procedure outcome.…”

Section: Discussionmentioning

confidence: 99%

“…However, little has been published about the optimal timing of intervention for thrombosed dialysis graft access. 5 The aim of this study was to investigate the effect of the time interval from clinical presentation of AVG thrombosis and the thrombectomy procedure by the AngioJet system in terms of technical and clinical success and to identify factors influencing success, if any.…”

Section: Introductionmentioning

confidence: 99%

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Factors influencing outcomes of rheolytic thrombectomy on thrombosed dialysis access grafts: Door to angiographic bed time and what else?

et al. 2020

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Background: The aim of this study was to investigate the effect of the time interval from clinical presentation of arteriovenous graft thrombosis and the thrombectomy procedure by the AngioJet system in terms of technical and clinical success and to identify factors influencing success. Methods: A total of 60 consecutive patients (35 men and 25 women; mean age = 52 ± 7.89 years) who had undergone percutaneous thrombectomy by the AngioJet device from 2016 to 2019 were retrospectively enrolled. Demographics and fistula data, previous treatments, time from clinical onset of thrombosis to intervention, procedural details and complications were recorded. Technical and clinical success and primary and secondary patency rates were calculated. One-way analysis of variance was performed to test any correlation between patient-related and fistula/procedure-related variables and technical/clinical success. Odds ratio and relative risk were also calculated when necessary. Results: Technical success and clinical success were 95% and 91.7%, respectively. Post-interventional primary and secondary patency rates at 1 year were 72.5% and 84.3%, respectively. Complication rate was 6.7%. One-way analysis of variance showed that clinical success was higher in patients with no previous treatment (p = 0.015). Furthermore, clinical success was significantly associated with door to angiographic bed time (p = 0.002): p-value for the 24-h and the 72-h cut-off was 0.012 and 0.006, respectively. Conclusion: Percutaneous rheolytic thrombectomy is safe and effective for thrombosed arteriovenous grafts, with acceptable primary and secondary patency rates. Higher clinical success was found in patients never treated before and when the procedure was carried out within 24 h from the clinical onset of thrombosis.

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

Cited by 9 publications

References 25 publications

Quality Improvement Guidelines for Percutaneous Image-Guided Management of the Thrombosed or Dysfunctional Dialysis Circuit

Quality Improvement Guidelines for Percutaneous Image-Guided Management of the Thrombosed or Dysfunctional Dialysis Circuit

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Factors influencing outcomes of rheolytic thrombectomy on thrombosed dialysis access grafts: Door to angiographic bed time and what else?

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