Korean J Thorac Cardiovasc Surg.  2009 Aug;42(4):487-491.

Comparative Analysis of Surgical Thrombectomy with Revision and Percutaneous Thrombectomy with Angioplasty for Treating Obstruction of a Dialysis Graft

• Lim JW
• Won YS
• Kim DH
• Shin HK

Abstract

BACKGROUND: Salvaging prosthetic arteriovenous grafts can be performed using surgical or endovascular techniques. We conducted a retrospective analysis to compare the efficacy of these two methods for restoring dialysis graft function. MATERIAL AND METHOD: We studied 41 patients who had received surgical thrombectomy with revision (Group A) or percutaneous thrombectomy with angioplasty (Group B) from January 2006 to December 2007. We compared them according to the patient characteristics and the location of stenotic lesions, and we analyzed the postintervention primary patency rates. RESULT: 21 patients underwent surgery and 20 patients underwent percutaneous balloon angioplasty. There were no significant differences of the patients' characteristics between the two groups. Venous anastomotic stenosis was the most common cause of graft thrombosis in both groups. In Group A, 90.5% of the grafts remained functional at 6 months and 38.1% remained functional at 12 months. In Group B, 55.0% of the grafts were functional at 6 months and 20.0% of the grafts were functional at 12 months. The post-intervention primary patency rate was significantly better in Group A (p=0.034).
CONCLUSION
Surgical treatment resulted in significantly longer post-intervention primary patency in this study, and this supports its use as the primary method of management for most patients in whom dialysis graft obstruction develops.

Keyword

Arteriovenous fistula; Intervention; Graft occlusion, vascular

MeSH Terms

Angioplasty
Angioplasty, Balloon
Arteriovenous Fistula
Constriction, Pathologic
Dialysis
Endovascular Procedures
Graft Occlusion, Vascular
Humans
Retrospective Studies
Thrombectomy
Thrombosis
Transplants