AngioJet Thrombectomy for Occluded Dialysis Fistulae: Outcome Data

Journal Article · Sun Mar 15 00:00:00 EDT 2009 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-008-9478-2· OSTI ID:21450284

Littler, Peter; Cullen, Nicola; Gould, Derek ^[1]; Bakran, Ali ^[2]; Powell, Steven ^[1]

---

1. Royal Liverpool University Hospital, Department of Radiology (United Kingdom)
2. Royal Liverpool University Hospital, Department of Transplant Surgery (United Kingdom)

This study evaluates AngioJet thrombectomy of occluded autogenous dialysis fistulae and polytetrafluoroethylene (PTFE) grafts in a UK hemodialysis population. Comparison is made with published data of alternative percutaneous thrombectomy methods. All patients with occluded dialysis fistulae who sought care at the Royal Liverpool University Hospital between October 2006 and June 2008 were included in the study. All patients were treated with the AngioJet Rheolytic Thrombectomy Device (Possis, Minneapolis, MN). Demographics, time of occlusion, adjunctive therapies, complications, and follow-up data have been prospectively recorded. A total of 64 thrombectomy procedures were performed in 48 patients. Forty-four autogenous fistulas were treated in 34 patients (19 brachiocephalic, 8 radiocephalic, and 7 transposed brachiobasilic). Twenty PTFE grafts were treated in 14 patients (9 brachioaxillary, 3 brachiocephalic loop grafts, 1 brachiobasilic, and 1 femoro-femoral). The average length of occlusion was 24 cm. Average time to intervention was 4 days. Immediate primary patency was 91%. Primary patency at 1, 3, and 6 months, respectively, was 71%, 60%, and 37%. Secondary patency at 3, 6, and 12 months was 87%, 77%, and 62%, respectively. Angioplasty was carried out in all procedures. Patients required stent insertion in 34 of the 64 thrombectomies to treat angioplasty-resistant stenoses. Complications included a puncture-site hematoma, and three angioplasty-related vein ruptures in one patient, all treated with covered stent grafts. Two cases of distal brachial arterial embolization were successfully treated by thrombosuction. AngioJet thrombectomy in dialysis access occlusion is safe and effective, comparing favorably with other methods.

• OSTI ID: 21450284
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 32, Issue 2; Other Information: DOI: 10.1007/s00270-008-9478-2; Copyright (c) 2009 Springer Science+Business Media, LLC; ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
DIALYSIS
FISTULAE
GRAFTS
RUPTURES
TEFLON
VEINS
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
FAILURES
FLUORINATED ALIPHATIC HYDROCARBONS
HALOGENATED ALIPHATIC HYDROCARBONS
MATERIALS
ORGANIC COMPOUNDS
ORGANIC FLUORINE COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANIC POLYMERS
ORGANS
PATHOLOGICAL CHANGES
PETROCHEMICALS
PETROLEUM PRODUCTS
PLASTICS
POLYETHYLENES
POLYMERS
POLYOLEFINS
POLYTETRAFLUOROETHYLENE
SEPARATION PROCESSES
SYNTHETIC MATERIALS
TRANSPLANTS