Hydrodynamic Thrombectomy System versus Pulse-Spray Thrombolysis for Thrombosed Hemodialysis Grafts: A Multicenter Prospective Randomized Comparison

Barth, Klemens H.; Gosnell, M.; Palestrant, Aubrey M.; Martin, Louis G.; Siegel, Jeffrey B.; Matalon, Terence A.S.; Goodwin, Scott C.; Neese, Paul; Swan, Timothy L.; Uflacker, Renan

doi:10.1148/radiology.217.3.r00nv33678

Cited by 58 publications

(26 citation statements)

References 26 publications

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“…Subsequently, other publications demonstrated equivalent efficacy of other devices when compared to thrombolytic therapy [5][6][7].…”

Section: Introductionmentioning

confidence: 97%

“…Accepted treatments for acutely occluded access grafts include surgery and thrombolytic therapy/angioplasty [3]. Several mechanical thrombectomy devices have been developed recently in efforts to lessen the invasiveness and cost of surgery and decrease complications related to thrombolytic therapy [4][5][6][7]. One of the first mechanical thrombectomy devices to be developed, and the first to be approved for the US market, was the Amplatz thrombectomy device (ATD); however, the final results in the trial comparing the ATD with surgical thromboembolectomy (ST) to declot occluded DAG had yet to be published.…”

Section: Introductionmentioning

confidence: 99%

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Thrombosed dialysis access grafts: randomized comparison of the Amplatz thrombectomy device and surgical thromboembolectomy

et al. 2004

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We report the final results of the trial comparing the Amplatz thrombectomy device (ATD) with surgical thromboembolectomy (ST) to declot thrombosed dialysis access grafts (DAG). The study population consisted of 174 DAG, 109 of which were randomized to mechanical thrombectomy using the ATD and 65 of which were randomized to conventional surgical thromboembolectomy. Forty grafts were re-enrolled in the trial when they failed beyond the 90 days follow-up after the initial treatment. Thirty-one were re-enrolled for mechanical thrombectomy and nine were re-enrolled for surgical thrombectomy, resulting in a total of 140 ATD procedures and 74 surgical thromboembolectomy. Immediate thrombectomy success was defined as greater than 90% thrombus removal followed by the ability to dialyze after treatment, and analysis of long term success based on graft patency at 30 and 90 days, with successful dialysis. Immediate thrombectomy success with the ATD procedure was achieved in 79.2% and with ST in 73.4%. Patency of the graft, with successful dialysis, at 30 days with the ATD procedure was 79.2% and with ST was 73.4%. Patency of the graft, with successful dialysis, at 90 days with the ATD procedure was 75.2% and with ST was 67.8%. The data collected in this study provided a prospective comparison of mechanical thrombectomy with the ATD and ST performance in thrombosed DAG. The results of the performance of both methods were comparable. No statistically significant differences were seen.

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“…Subsequently, other publications demonstrated equivalent efficacy of other devices when compared to thrombolytic therapy [5][6][7].…”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Thrombosed dialysis access grafts: randomized comparison of the Amplatz thrombectomy device and surgical thromboembolectomy

et al. 2004

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“…XCOIL TM uses a series of loops that are placed around the thrombus to "cocoon" the clot, and the loops are then retracted to keep the thrombus from fragmenting during withdrawal (11 , 20). Studies of the XCOIL TM using a pulsatile flow model, similar to that described by Müller-Hülsbeck et al (14), have demonstrated no significant fragmentation or distal embolization (unpublished communication). Distal embolization into the adjacent artery occurred in one case (5.5%).…”

Section: Xcoilmentioning

confidence: 52%

“…The AngioJet device is reported to have a 6% to 10% rate of hemorrhagic complications, distal embolization, and vessel dissection during arterial interventions (13). An 11% occurrence of adverse events has been reported with use of hydrodynamic thrombectomy devices during dialysis graft declot procedures (14). Current arterial thrombectomy devices have a 2%-18% rate of distal embolization (13,(15)(16)(17)(18)(19), including an 11% incidence of distal embolization for the Trellis device (Bacchus Vascular) (17).…”

Section: Xcoilmentioning

confidence: 99%

Initial clinical use of a novel mechanical thrombectomy device, XCOILTM, in hemodialysis graft and fistula declot procedures

Monsky

Latchaw

2016

Diagn Interv Radiol

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“…These results were much better than those for surgical thrombectomy alone [10,11]. In addition, the results of the hybrid method were much better than thrombolytic therapy alone [12][13][14][15]. Lee et al studied the practice of mechanical thrombectomy, with or without thrombolytic agents, and reported an immediate success rate of 89.3%, but at 4 m follow-up, the vascular access patency declined to 25.6% [16].…”

Section: Discussionmentioning

confidence: 99%

Hybrid Therapy Using a Surgical Thrombectomy with a Balloon Angioplasty to Regain Thrombosed Dialysis Vascular Access-Clinical Case Series

Davoodi¹,

Farsavian²,

Farsavian³

2017

Surgery Curr Res

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Introduction: Thrombectomy is the most common surgical method used to re-establish thrombosed vascular access, particularly in hemodialysis patients. To achieve better patient outcomes and to improve the prognosis for surgical thrombectomy, fistulography with balloon angioplasty to assist during surgery has been introduced in recent years. Methods:In this study, the results of hybrid therapy in 53 patients with thrombosed vascular access were examined. The success rate for re-opening vascular access and dialysis success were recorded, immediately, and at 1 m and 6 m after the surgical procedure.Results: Of 53 patients, 40 patients underwent balloon angioplasty. The success rate in the first session of dialysis after surgery was 85%. At 1 m and 6 m, the dialysis success rates were 75% and 55%, respectively. Conclusion:The use of hybrid method to re-establish vascular access in hemodialysis patients was not only quite effective but also showed several advantages over other conventional methods. Using this method, possible thrombotic lesions were evaluated and corrected with balloon angioplasty. In addition to reducing the risk of recurrent path failure, all these procedures can be performed during one session in the operating room, which led to reductions in surgical and recovery time and costs for both the surgeons and the patients.

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Hydrodynamic Thrombectomy System versus Pulse-Spray Thrombolysis for Thrombosed Hemodialysis Grafts: A Multicenter Prospective Randomized Comparison

Abstract: The hydrodynamic thrombectomy system is at least as efficacious and safe as pulse-spray thrombolysis but shortens thrombus treatment time.

Cited by 58 publications

References 26 publications

Thrombosed dialysis access grafts: randomized comparison of the Amplatz thrombectomy device and surgical thromboembolectomy

Thrombosed dialysis access grafts: randomized comparison of the Amplatz thrombectomy device and surgical thromboembolectomy

Initial clinical use of a novel mechanical thrombectomy device, XCOILTM, in hemodialysis graft and fistula declot procedures

Hybrid Therapy Using a Surgical Thrombectomy with a Balloon Angioplasty to Regain Thrombosed Dialysis Vascular Access-Clinical Case Series

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