Objective: The objective of our study was to evaluate outcomes of percutaneous declotting procedures in patients with prosthetic femoral dialysis grafts.
Materials And Methods: A retrospective review of all pharmacomechanical femoral dialysis graft declotting procedures performed in our hospital between May 11, 1993, and April 30, 2003, was performed. A total of 110 procedures were performed on 25 patients (nine males, 16 females; age range, 17-80 years; mean age, 49 years) with 30 grafts.
Results: Technical success was 97.3%. Using life table analysis, 30-day postinterventional primary patency was 72%, 90-day primary patency was 46%, 180-day primary patency was 25%, and 365-day primary patency was 4%. The 30-day secondary postinterventional patency was 93%, 90-day secondary patency was 86%, 180-day secondary patency was 76%, and the 365-day secondary patency was 51%. An average of 1.96 declotting procedures were performed per year of dialysis.
Conclusion: Percutaneous declotting of femoral hemodialysis grafts has technical success and patency rates similar to those for percutaneous declotting in the upper extremities. Results of this series exceeded criteria established by the National Kidney Foundation in the "Dialysis Outcome Quality Initiative" for immediate patency and unassisted 3-month patency.
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http://dx.doi.org/10.2214/AJR.04.0693 | DOI Listing |
J Vasc Access
August 2024
Department of Internal Medicine, Section of Nephrology, University of Chicago Medical Center, Chicago, IL, USA.
Background: Thrombosis of the vascular access in patients with end-stage renal disease requiring hemodialysis are common and require timely interventional procedures to restore patency. The aim of the current study was to identify factors having a significant effect on patency rates after access thrombosis. Our hypothesis was the length of time between the initial clotting of the access and the subsequent percutaneous declotting impacts the patency rates of the vascular access.
View Article and Find Full Text PDFWhile rare, coronary stent infections present with significant mortality-with most infections and further complications occurring within months of percutaneous coronary intervention (PCI). Here, we discuss a post-COVID-19 patient who presented approximately one year after PCI for declotting of an arteriovenous graft (AVG). Upon admission, the patient was found to be bacteremic with multilobar pneumonia and an infection of the AVG.
View Article and Find Full Text PDFCardiovasc Intervent Radiol
September 2023
Department of Radiology, University Hospitals KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
Thrombotic occlusion of autologous arteriovenous fistulas or synthetic arteriovenous grafts is a serious adverse event in hemodialysis patients and declotting should be performed before next hemodialysis session, in order to avoid a central venous catheter. Various techniques exist to declot a thrombosed vascular access, including open surgical thrombectomy, catheter-directed thrombolysis and use of different types of percutaneous thrombo-aspiration catheters and mechanical thrombectomy devices. These devices can be categorized as devices with direct wall contact and hydrodynamic devices without direct wall contact.
View Article and Find Full Text PDFCardiovasc Intervent Radiol
February 2023
Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, 9200 W. Wisconsin Ave. Room 2803, Milwaukee, WI, 53226, USA.
Purpose: The purpose of this study was to elicit the relationship of antiplatelet therapy (AP) in maintaining arteriovenous graft (AVG) patency after successful percutaneous pharmacomechanical thrombectomy ("declot").
Materials And Methods: This was an institutional review board-approved retrospective review of AVG declot procedures between July 2019 and August 2020. AVG characteristics, bleeding complications, anticoagulation and antiplatelet medication regimens, and thrombosis free survival were evaluated.
J Vasc Interv Radiol
January 2022
Interventional Radiology Department, Patras University Hospital, Patras, Greece.
Purpose: To retrospectively assess the safety and efficacy of percutaneous arteriovenous fistula (pAVF) creation with the WavelinQ 4-F EndoAVF System.
Materials And Methods: From February 2018 to June 2020, 30 pAVFs were created in 30 consecutive patients (men; age, 55.3 years ± 13.
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