Percutaneous management of acutely thrombosed hemodialysis grafts: The double balloon occlusion technique

Abstract

The DBOT has the potential to be operated safely and effectively. Preliminary results had high success rates and patency rates. With basic devices, it may serve as an option to rescue thrombosed grafts. More data are needed to identify its clinical role.

Vacuum-assisted mechanical thrombectomy in extensively occlusive thrombosis of dialysis arteriovenous grafts with indigo system

“…This is similar to other studies (range = 76%-100% and 20%-91%, respectively). 4,6,24,[27][28][29][30][31][32][33][34][35][36][37][38] More in detail, Marcelin et al 24 recently evaluated the Indigo System in AVF/AVG occlusion, reporting technical and clinical success of clot removal of 97.1% and 91%, respectively. We report a 6-month primary patency, primary-assisted patency, and secondary patency of 37.5%, 50.0%, and 62.5%, respectively.…”

“…This is similar to other studies (range = 38.1-126 min). 24,[27][28][29]34 We reported 2 complications during the procedure, acute peripheral ischemia distally to AVG in one case (10%) and mild hemorrhage of the working sheath access after the procedure, requiring suture performed at patient bed in the other case. Arterial embolization has been reported in the literature to range from 0% to 13% with other systems.…”

Post-angioplasty Far Infrared Radiation Therapy Improves 1-Year Angioplasty-Free Hemodialysis Access Patency of Recurrent Obstructive Lesions

“…The inflated pressure was gradually increased until the lesion was totally dilated or the pressure reached the level of rated burst pressure. The double balloon occlusion technique, previously documented to be safe and effective for thrombectomy, 26 was implemented for salvaging acutely thrombosed AVGs despite the other techniques for thrombectomy reported. 27 In addition, thromboaspiration and pharmacologic thrombolysis (urokinase) were permitted for rescuing acutely thrombosed accesses.…”

A one-sheath inverse method in vascular access intervention therapy for hemodialysis patients

“…VAIVT for arteriovenous graft is most commonly performed using an approach through the graft. Stenosis usually develops at the site of venous anastomosis of the graft and thrombus tends to form within the graft [7,8]. In order to ensure satisfactory inflow and outflow in such cases, sheaths are inserted from opposite sides of the graft on the upstream and downstream sides to perform thrombectomy and PTA.…”