Korean Journal of Radiology

  • 제13권3호
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  • Pages.300-306
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  • 2012
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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DOI QR코드

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Efficacy of a Modified Pharmacomechanical Thrombolysis Technique for Endovascular Treatment of Thrombosed Prosthetic Arteriovenous Grafts

  • Choi, Sun-Young (Department of Radiology and Medical Research Institute, School of Medicine, Ewha Womans University) ;
  • Choi, Byung-Gil (Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Han, Kum-Hyun (Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Chun, Ho-Jong (Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital)
  • 발행 : 2012.06.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: We applied a modified pharmacomechanical thrombolysis (PMT) technique to endovascular treatment of thrombosed arteriovenous (AV) grafts without the use of any mechanical thrombectomy devices. The aim of this study was to evaluate the efficacy of the PMT technique in the treatment of thrombosed AV grafts by analyzing the long-term patency. Materials and Methods: Eighty-two patients with thrombosed AV grafts were treated with the PMT technique. AV graft surveillance to detect failing/failed access was followed by endovascular treatment. Results: The technical and clinical success rates were 95% and 95%, respectively. The total number of thrombolysis sessions was 279. A post-intervention primary patency rate was 45% and 22% at 12 and 24 months, respectively. The secondary patency rate was 96% and 91% at 12 and 24 months, respectively. No major complications were noticed. Conclusion: The modified PMT technique is effective in endovascular treatment of thrombosed AV grafts.

키워드

참고문헌

  1. Clinical practice guidelines for vascular access. Am J Kidney Dis 2006;48 Suppl 1:S176-S247 https://doi.org/10.1053/j.ajkd.2006.04.029
  2. Bookstein JJ, Fellmeth B, Roberts A, Valji K, Davis G, Machado T. Pulsed-spray pharmacomechanical thrombolysis: preliminary clinical results. AJR Am J Roentgenol 1989;152:1097-1100 https://doi.org/10.2214/ajr.152.5.1097
  3. Cynamon J, Lakritz PS, Wahl SI, Bakal CW, Sprayregen S. Hemodialysis graft declotting: description of the "lyse and wait" technique. J Vasc Interv Radiol 1997;8:825-829 https://doi.org/10.1016/S1051-0443(97)70667-5
  4. Valji K, Bookstein JJ, Roberts AC, Davis GB. Pharmacomechanical thrombolysis and angioplasty in the management of clotted hemodialysis grafts: early and late clinical results. Radiology 1991;178:243-247 https://doi.org/10.1148/radiology.178.1.1824582
  5. Cho SK, Han H, Kim SS, Lee JY, Shin SW, Do YS, et al. Percutaneous treatment of failed native dialysis fistulas: use of pulse-spray pharmacomechanical thrombolysis as the primary mode of therapy. Korean J Radiol 2006;7:180-186
  6. Middlebrook MR, Amygdalos MA, Soulen MC, Haskal ZJ, Shlansky-Goldberg RD, Cope C, et al. Thrombosed hemodialysis grafts: percutaneous mechanical balloon declotting versus thrombolysis. Radiology 1995;196:73-77 https://doi.org/10.1148/radiology.196.1.7784593
  7. Park BJ, Kim HR, Chung HH, Sung DJ, Park SJ, Son HS, et al. Percutaneous intervention in axillary loop-configured arteriovenous grafts for chronic hemodialysis patients. Korean J Radiol 2010;11:195-202 https://doi.org/10.3348/kjr.2010.11.2.195
  8. Hathaway PB, Vesely TM. The apex-puncture technique for mechanical thrombolysis of loop hemodialysis grafts. J Vasc Interv Radiol 1999;10:775-779 https://doi.org/10.1016/S1051-0443(99)70113-2
  9. Wu CC, Lin MC, Pu SY, Tsai KC, Wen SC. Comparison of cutting balloon versus high-pressure balloon angioplasty for resistant venous stenoses of native hemodialysis fistulas. J Vasc Interv Radiol 2008;19:877-883 https://doi.org/10.1016/j.jvir.2008.02.016
  10. Wu CC, Wen SC. Cutting balloon angioplasty for resistant venous stenoses of dialysis access: immediate and patency results. Catheter Cardiovasc Interv 2008;71:250-254 https://doi.org/10.1002/ccd.21402
  11. Vorwerk D, Konner K, Schurmann K, Gunther RW. A simple trick to facilitate bleeding control after percutaneous hemodialysis fistula and graft interventions. Cardiovasc Intervent Radiol 1997;20:159-160 https://doi.org/10.1007/s002709900127
  12. Sidawy AN, Gray R, Besarab A, Henry M, Ascher E, Silva M Jr, et al. Recommended standards for reports dealing with arteriovenous hemodialysis accesses. J Vasc Surg 2002;35:603- 610 https://doi.org/10.1067/mva.2002.122025
  13. Gray RJ, Sacks D, Martin LG, Trerotola SO. Reporting standards for percutaneous interventions in dialysis access. J Vasc Interv Radiol 2003;14:S433-S442 https://doi.org/10.1097/01.RVI.0000094618.61428.58
  14. Aruny JE, Lewis CA, Cardella JF, Cole PE, Davis A, Drooz AT, et al. Quality improvement guidelines for percutaneous management of the thrombosed or dysfunctional dialysis access. J Vasc Interv Radiol 2003;14:S247-S253 https://doi.org/10.1097/01.RVI.0000058328.82956.15
  15. Trerotola SO, Lund GB, Scheel PJ Jr, Savader SJ, Venbrux AC, Osterman FA Jr. Thrombosed dialysis access grafts: percutaneous mechanical declotting without urokinase. Radiology 1994;191:721-726 https://doi.org/10.1148/radiology.191.3.8184052
  16. Schmitz-Rode T, Pfeffer JG, Bohndorf K, Gunther RW. Percutaneous thrombectomy of the acutely thrombosed dialysis graft: in vitro evaluation of four devices. Cardiovasc Intervent Radiol 1993;16:72-75 https://doi.org/10.1007/BF02602981
  17. Kakkos SK, Andrzejewski T, Haddad JA, Haddad GK, Reddy DJ, Nypaver TJ, et al. Equivalent secondary patency rates of upper extremity Vectra Vascular Access Grafts and transposed brachial-basilic fistulas with aggressive access surveillance and endovascular treatment. J Vasc Surg 2008;47:407-414 https://doi.org/10.1016/j.jvs.2007.09.061
  18. Kakkos SK, Haddad R, Haddad GK, Reddy DJ, Nypaver TJ, Lin JC, et al. Results of aggressive graft surveillance and endovascular treatment on secondary patency rates of Vectra Vascular Access Grafts. J Vasc Surg 2007;45:974-980 https://doi.org/10.1016/j.jvs.2007.01.011
  19. Kakkos SK, Haddad GK, Haddad J, Scully MM. Percutaneous rheolytic thrombectomy for thrombosed autogenous fistulae and prosthetic arteriovenous grafts: outcome after aggressive surveillance and endovascular management. J Endovasc Ther 2008;15:91-102 https://doi.org/10.1583/07-2239.1
  20. Uflacker R, Rajagopalan PR, Vujic I, Stutley JE. Treatment of thrombosed dialysis access grafts: randomized trial of surgical thrombectomy versus mechanical thrombectomy with the Amplatz device. J Vasc Interv Radiol 1996;7:185-192 https://doi.org/10.1016/S1051-0443(96)70760-1
  21. Valji K, Bookstein JJ, Roberts AC, Oglevie SB, Pittman C, O'Neill MP. Pulse-spray pharmacomechanical thrombolysis of thrombosed hemodialysis access grafts: long-term experience and comparison of original and current techniques. AJR Am J Roentgenol 1995;164:1495-1500; discussion 1501-1503 https://doi.org/10.2214/ajr.164.6.7754901
  22. Cohen MA, Kumpe DA, Durham JD, Zwerdlinger SC. Improved treatment of thrombosed hemodialysis access sites with thrombolysis and angioplasty. Kidney Int 1994;46:1375-1380 https://doi.org/10.1038/ki.1994.407
  23. Beathard GA, Welch BR, Maidment HJ. Mechanical thrombolysis for the treatment of thrombosed hemodialysis access grafts. Radiology 1996;200:711-716 https://doi.org/10.1148/radiology.200.3.8756920
  24. Trerotola SO, Vesely TM, Lund GB, Soulen MC, Ehrman KO, Cardella JF. Treatment of thrombosed hemodialysis access grafts: Arrow-Trerotola percutaneous thrombolytic device versus pulse-spray thrombolysis. Arrow-Trerotola Percutaneous Thrombolytic Device Clinical Trial. Radiology 1998;206:403- 414 https://doi.org/10.1148/radiology.206.2.9457193
  25. Soulen MC, Zaetta JM, Amygdalos MA, Baum RA, Haskal ZJ, Shlansky-Goldberg RD. Mechanical declotting of thrombosed dialysis grafts: experience in 86 cases. J Vasc Interv Radiol 1997;8:563-567 https://doi.org/10.1016/S1051-0443(97)70609-2
  26. Yoffe B, Behar DJ, Scheinowitz M, Rabin AM. A new mechanical device for declotting of hemodialysis access grafts: first clinical experience. J Endovasc Ther 2005;12:215- 223 https://doi.org/10.1583/04-1270R.1
  27. Uflacker R, Rajagopalan PR, Selby JB, Hannegan C. Thrombosed dialysis access grafts: randomized comparison of the Amplatz thrombectomy device and surgical thromboembolectomy. Eur Radiol 2004;14:2009-2014 https://doi.org/10.1007/s00330-004-2422-1

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  9. Outcomes of Catheter-Directed Thrombolysis for Arteriovenous Fistula Thrombosis in Singapore: Is It Still Relevant Today? vol.14, pp.1, 2021, https://doi.org/10.3400/avd.oa.20-00112