J Korean Radiol Soc.  2000 Oct;43(4):411-416. 10.3348/jkrs.2000.43.4.411.

Percutaneous Mechanical Declotting of Thrombosed Dialysis Graft

• Yang SB
• Goo DE
• Kim DH
• Lee HK
• Choi DL
• Kwon KH
• Hong HS
• Moon C

• KMID: 1945499
• DOI: http://doi.org/10.3348/jkrs.2000.43.4.411

Abstract

PURPOSE: To evaluate the effectiveness of percutaneous mechanical declotting in thrombosed dialysis graft.
MATERIALS AND METHODS
Thirty-two patients with thrombosed dialysis graft in 260 cases involving insufficient hemodialytic access underwent mechanical declotting. Using a 7-F Desilets-Hoffman sheath and the crossed-catheter technique, we aspirated the intragraft clot and pushed the residual clot into the central circulation with balloon catheters. The success rate, procedure time, complications and patency rates were evaluated.
RESULTS
Technical success was achieved in 24 of 32 cases, with a procedure time of 30 -240 (average, 111) minutes. In five of eight cases in which technical failure occurred, the guide wire failed to reach the stenotic site and in the other three, there was insufficient luminal dilatation. Complications included vein ruptures (n=2), arterial emboli (n=1) and arterial dissection (1), but there was no evidence of clinical symptoms of pulmonary embolism. The six-month patency rate was 67.8%.
CONCLUSION
Mechanical declotting of thrombosed dialysis graft using a balloon catheter is relatively inexpensive, safe and fast, and is well tolerated.

Keyword

Dialysis, shunts; Vein, transluminal angioplasty; Thrombectomy

MeSH Terms

Catheters
Dialysis*
Dilatation
Humans
Phenobarbital
Pulmonary Embolism
Rupture
Thrombectomy
Transplants*
Veins
Phenobarbital