Perioperative and long-term outcomes after percutaneous thrombectomy of arteriovenous dialysis access grafts

Arinze, Nkiruka; Ryan, Tyler; Pillai, Rahul; Vilvendhan, Rajendran; Farber, Alik; Jones, Douglas W.; Rybin, Denis; Levin, Scott R.; Cheng, Thomas W.; Siracuse, Jeffrey J.

doi:10.1016/j.jvs.2020.03.032

Cited by 7 publications

(3 citation statements)

References 27 publications

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“…The median post‐intervention primary patency in this study was slightly higher than our previous study 6 (9.0 months vs. 7.4 months). Additionally, the post‐intervention primary patency rate in our study at 1 month was comparable to previous studies, which ranged from 68% to 90%, 16–18 whereas the 3 and 6 months post‐intervention primary patency rates were slightly better than the previous studies 19–21 . The reason for reasonably good results in this study, compared to previous studies, 16–21 was due to system improvement, including equipment, machines, procedural techniques, and the experience of the operators.…”

Section: Discussionsupporting

confidence: 79%

The related factors to the re‐thrombosis of hemodialysis arteriovenous graft after endovascular salvage

Janjindamai

Hongsakul

Sungsiri

et al. 2022

Seminars in Dialysis

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Background: Only a few issues of the related factors to hemodialysis access dysfunction have been evaluated, and the effects of antiplatelets to improve the patency of hemodialysis access remained controversial. Hence, this study aimed to determine the related factors to the re-thrombosis of arteriovenous grafts (AVGs) after endovascular treatment.Methods: This retrospective study was conducted at a university-affiliated teaching hospital in Southern Thailand. All patients who underwent hemodialysis with thrombosed AVG, who had pharmacomechanical thrombolysis from January 2016 to December 2018, were enrolled. Post-intervention primary patency was analyzed by the Kaplan-Meier method, and the related factors to the re-thrombosis of AVG were evaluated using logistic regression.Results: A total of 157 patients with thrombosed hemodialysis AVG were enrolled.The most common graft location and configuration was a forearm loop graft (65%).Post-intervention primary patency rate at 1, 3, and 6 months were 79.0%, 67.1%, and 54.0%, respectively. Diabetes mellitus (DM) was a significant related factor for re-thrombosis (hazard ratio [HR], 1.89; 95% confidence interval [CI], 1.20-2.98; p = 0.006). A single antiplatelet after the procedure was a protective factor for rethrombosis (HR, 0.58; 95% CI, 0.38-0.89; p = 0.013). The median post-intervention primary patency was 15.7 months in the group of single antiplatelet usage, which was better than that of the non-antiplatelet group (p = 0.012).Conclusion: DM and antiplatelet usage were significant related factors to the rethrombosis of hemodialysis AVG after endovascular salvage.

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Section: Discussionsupporting

confidence: 79%

The related factors to the re‐thrombosis of hemodialysis arteriovenous graft after endovascular salvage

Janjindamai

Hongsakul

Sungsiri

et al. 2022

Seminars in Dialysis

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“…It is the first time that we adopt the IST to treat the thrombosis on LVAD. Here, we review clinical studies about thrombolytic technologies on implantable and interventional devices in recent years [ 2 , 3 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] and compare the IST with other currently used thrombolytic technologies, including medical therapy, pump exchange, sonothrombolysis, washout maneuver, and mechanical thrombectomy. Safety and efficiency are focused on in the evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…Although it shows a good success ratio, the risk is still high because the thrombus washed from LVAD will enter other organs. [ 3 , 27 ] Mechanical thrombectomy is currently widely used in vascular graft thrombosis, [ 28 , 29 , 30 , 31 , 32 ] but this therapy has a risk of damaging the inner wall of the blood vessels in the treatment site. Sonothrombolysis has been widely used in vein bypass grafts thrombolysis: the ultrasonic probe is inserted into the thrombus through intervention of the catheter.…”

Section: Discussionmentioning

confidence: 99%

Interventional Microbubble Enhanced Sonothrombolysis on Left Ventricular Assist Devices

et al. 2022

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The left ventricular assist device (LVAD) is often used in the treatment of heart failure. However, 4% to 9% implanted LVAD will have thrombosis problem in one year, which is fatal to the patient's life. In this work, an interventional sonothrombolysis (IST) method is developed to realize the thrombolysis on LVAD. A pair of ultrasound transducer rings is installed on the shell of LVAD, and drug-loaded microbubbles are injected into the LVAD through the interventional method. The microbubbles are adhere on the thrombus with the coated thrombus-targeted drugs, and the thrombolytic drugs carried by the bubbles are brought into the thrombus by the cavitation of bubbles under the ultrasound. In a proof-of-concept experiment in a live sheep model, the thrombus on LVAD is dissolved in 30 min, without damages on LVADs and organs. This IST exhibits to be more efficient and safer compared with other thrombolysis methods on LVAD.

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Comparing Patency Rates of Arteriovenous Dialysis Access following Percutaneous Thrombectomy Using Various Catheter Directed Therapies

Hicks¹,

Grzeda²,

Schucht³

et al. 2023

Annals of Vascular Surgery

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Perioperative and long-term outcomes after percutaneous thrombectomy of arteriovenous dialysis access grafts

Cited by 7 publications

References 27 publications

The related factors to the re‐thrombosis of hemodialysis arteriovenous graft after endovascular salvage

The related factors to the re‐thrombosis of hemodialysis arteriovenous graft after endovascular salvage

Interventional Microbubble Enhanced Sonothrombolysis on Left Ventricular Assist Devices

Comparing Patency Rates of Arteriovenous Dialysis Access following Percutaneous Thrombectomy Using Various Catheter Directed Therapies

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