Korean J Radiol.  2012 Jun;13(3):300-306. 10.3348/kjr.2012.13.3.300.

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

• Choi SY
• Choi BG
• Han KH
• Chun HJ

• KMID: 1372849
• DOI: http://doi.org/10.3348/kjr.2012.13.3.300

Abstract

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.

Keyword

Hemodialysis access; Prosthetic arteriovenous grafts; Pharmacomechanical thrombolysis; Urokinase; Balloon angioplasty

MeSH Terms

Adult
Aged
Aged, 80 and over
Angiography
Angioplasty, Balloon
*Arteriovenous Shunt, Surgical
Female
Graft Occlusion, Vascular/*therapy
Hemostatic Techniques
Humans
Male
Middle Aged
Polytetrafluoroethylene
Proportional Hazards Models
Radiography, Interventional
Renal Dialysis
Retrospective Studies
Stents
Thrombolytic Therapy/*methods
Treatment Outcome
Vascular Patency

Figure

• 

  Fig. 1 Kaplan-Meier curves of overall post-intervention primary and secondary patencies of thrombosed arteriovenous grafts. Censored data are indicated by vertical bars at data points.

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