skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Endovascular Revascularization of Hemodialysis Thrombosed Grafts with the Hydrodynamic Thrombectomy Catheter. Our 7-Year Experience

Abstract

PurposeTo evaluate the efficacy and safety of the hydrodynamic thrombectomy catheter (AngioJet DVX) in the salvage of thrombosed hemodialysis vascular grafts.Materials and MethodsA retrospective study was designed, including all patients with occluded arteriovenous grafts treated with the AngioJet system between 2007 and 2014 in our institution. Outcomes included technical success, clinical success, complications, and primary and secondary patencies. Procedural success was defined as angiographic confirmation of flow restoration, the presence of a pulsatile thrill along the graft, and successful resumption of at least one hemodialysis session. Primary and secondary patencies after first AVG thrombectomy were calculated with Kaplan–Meier curves. Cox regression was used to determine prognostic factors of primary patency after every thrombectomy episode.ResultsA total of 149 thrombectomies were performed in 68 grafts. After thrombectomy, endovascular treatment of one or more stenosis was performed in all cases. Technical success was 93% and clinical success was 86%. Complications occurred in 7 thrombectomies, most of them were minor except for one anastomosis rupture requiring surgery. Primary and secondary patencies were 52, 41, and 23 and 76, 68, and 57% at 3, 6 and 12 months, respectively. Independent prognostic factors of poor patency after every thrombectomy episode were the presence of residual thrombus (ORmore » 1.831, P = 0.008) and time from last thrombosis (less than 1 month; and OR 7.116, P < 0.001).ConclusionPercutaneous mechanical thrombectomy with AngioJet is a safe technique with a high-clinical success rate. The presence of residual thrombus after thrombectomy and early re-occlusions are related to poorer results.« less

Authors:
 [1];  [2];  [3]; ; ; ; ; ;  [1]
  1. Clinic Hospital of Barcelona, Vascular and Interventional Radiology Unit, Diagnostic Imaging Institute (Spain)
  2. Clinic Hospital of Barcelona, Vascular Access Unit, Nephrologic and Urologic Diseases Clinical Institute (Spain)
  3. Clinic Hospital of Barcelona, Cardiovascular Diseases Institute (Spain)
Publication Date:
OSTI Identifier:
22645339
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 2; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOLOGICAL RECOVERY; GRAFTS; HYDRODYNAMICS; PATIENTS; RUPTURES; SAFETY; SURGERY; THROMBOSIS

Citation Formats

Bermudez, Patrícia, E-mail: pbermude@clinic.ub.es, Fontseré, Nestor, E-mail: fontsere@clinic.ub.es, Mestres, Gaspar, E-mail: gmestres@clinic.ub.es, García-Gámez, Andres, E-mail: garciagam@clinic.ub.es, Barrufet, Marta, E-mail: barrufet@clinic.ub.es, Burrel, Marta, E-mail: mburrel@clinic.ub.es, Gilabert, Rosa, E-mail: gilabert@clinic.ub.es, Gómez, Fernando, E-mail: fegomez@clinic.ub.es, and Macho, Juan, E-mail: jmmacho@clinic.ub.es. Endovascular Revascularization of Hemodialysis Thrombosed Grafts with the Hydrodynamic Thrombectomy Catheter. Our 7-Year Experience. United States: N. p., 2017. Web. doi:10.1007/S00270-016-1488-X.
Bermudez, Patrícia, E-mail: pbermude@clinic.ub.es, Fontseré, Nestor, E-mail: fontsere@clinic.ub.es, Mestres, Gaspar, E-mail: gmestres@clinic.ub.es, García-Gámez, Andres, E-mail: garciagam@clinic.ub.es, Barrufet, Marta, E-mail: barrufet@clinic.ub.es, Burrel, Marta, E-mail: mburrel@clinic.ub.es, Gilabert, Rosa, E-mail: gilabert@clinic.ub.es, Gómez, Fernando, E-mail: fegomez@clinic.ub.es, & Macho, Juan, E-mail: jmmacho@clinic.ub.es. Endovascular Revascularization of Hemodialysis Thrombosed Grafts with the Hydrodynamic Thrombectomy Catheter. Our 7-Year Experience. United States. doi:10.1007/S00270-016-1488-X.
Bermudez, Patrícia, E-mail: pbermude@clinic.ub.es, Fontseré, Nestor, E-mail: fontsere@clinic.ub.es, Mestres, Gaspar, E-mail: gmestres@clinic.ub.es, García-Gámez, Andres, E-mail: garciagam@clinic.ub.es, Barrufet, Marta, E-mail: barrufet@clinic.ub.es, Burrel, Marta, E-mail: mburrel@clinic.ub.es, Gilabert, Rosa, E-mail: gilabert@clinic.ub.es, Gómez, Fernando, E-mail: fegomez@clinic.ub.es, and Macho, Juan, E-mail: jmmacho@clinic.ub.es. Wed . "Endovascular Revascularization of Hemodialysis Thrombosed Grafts with the Hydrodynamic Thrombectomy Catheter. Our 7-Year Experience". United States. doi:10.1007/S00270-016-1488-X.
@article{osti_22645339,
title = {Endovascular Revascularization of Hemodialysis Thrombosed Grafts with the Hydrodynamic Thrombectomy Catheter. Our 7-Year Experience},
author = {Bermudez, Patrícia, E-mail: pbermude@clinic.ub.es and Fontseré, Nestor, E-mail: fontsere@clinic.ub.es and Mestres, Gaspar, E-mail: gmestres@clinic.ub.es and García-Gámez, Andres, E-mail: garciagam@clinic.ub.es and Barrufet, Marta, E-mail: barrufet@clinic.ub.es and Burrel, Marta, E-mail: mburrel@clinic.ub.es and Gilabert, Rosa, E-mail: gilabert@clinic.ub.es and Gómez, Fernando, E-mail: fegomez@clinic.ub.es and Macho, Juan, E-mail: jmmacho@clinic.ub.es},
abstractNote = {PurposeTo evaluate the efficacy and safety of the hydrodynamic thrombectomy catheter (AngioJet DVX) in the salvage of thrombosed hemodialysis vascular grafts.Materials and MethodsA retrospective study was designed, including all patients with occluded arteriovenous grafts treated with the AngioJet system between 2007 and 2014 in our institution. Outcomes included technical success, clinical success, complications, and primary and secondary patencies. Procedural success was defined as angiographic confirmation of flow restoration, the presence of a pulsatile thrill along the graft, and successful resumption of at least one hemodialysis session. Primary and secondary patencies after first AVG thrombectomy were calculated with Kaplan–Meier curves. Cox regression was used to determine prognostic factors of primary patency after every thrombectomy episode.ResultsA total of 149 thrombectomies were performed in 68 grafts. After thrombectomy, endovascular treatment of one or more stenosis was performed in all cases. Technical success was 93% and clinical success was 86%. Complications occurred in 7 thrombectomies, most of them were minor except for one anastomosis rupture requiring surgery. Primary and secondary patencies were 52, 41, and 23 and 76, 68, and 57% at 3, 6 and 12 months, respectively. Independent prognostic factors of poor patency after every thrombectomy episode were the presence of residual thrombus (OR 1.831, P = 0.008) and time from last thrombosis (less than 1 month; and OR 7.116, P < 0.001).ConclusionPercutaneous mechanical thrombectomy with AngioJet is a safe technique with a high-clinical success rate. The presence of residual thrombus after thrombectomy and early re-occlusions are related to poorer results.},
doi = {10.1007/S00270-016-1488-X},
journal = {Cardiovascular and Interventional Radiology},
number = 2,
volume = 40,
place = {United States},
year = {Wed Feb 15 00:00:00 EST 2017},
month = {Wed Feb 15 00:00:00 EST 2017}
}