Single-centre experience with endovascular rotational thrombectomy for single session salvage of thrombosed arteriovenous fistulas and grafts.

Autor:	Lim C; Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore., Kwan J; Vascular and Interventional Radiology, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore., Lo ZJ; Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore., Hong Q; Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore., Zhang L; Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore., Chong L; Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore., Huang IKH; Vascular and Interventional Radiology, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore., Lim GHT; Vascular and Interventional Radiology, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore., Quek LHH; Vascular and Interventional Radiology, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore., Pua U; Vascular and Interventional Radiology, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore., Punamiya S; Vascular and Interventional Radiology, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore., Chandrasekar S; Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore., Tan GWL; Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore., Yong E; Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore.
Jazyk:	angličtina
Zdroj:	The journal of vascular access [J Vasc Access] 2023 Sep; Vol. 24 (5), pp. 965-971. Date of Electronic Publication: 2021 Nov 29.
DOI:	10.1177/11297298211060964
Abstrakt:	Objectives: This paper documents our experience and outcomes of using a relatively new endovascular rotational thrombectomy device for salvage of thrombosed vascular access. Methodology: A retrospective study reviewing patients with thrombosed native AVF or AVG who underwent endovascular declotting using a rotational thrombectomy device between November 2018 and May 2020 at a tertiary university hospital in Southeast Asia. We evaluated demographics, procedural data, technical and procedural success, patency rates and complications. Results: A total of 40 patients underwent single session endovascular declotting of thrombosed vascular access. The mean follow-up period was 21.6 months (range 13.4-31 months). The technical success was 92.5% and clinical success was 80%. About 50% of patients had concomitant thrombolysis for pharmacomechanical thrombectomy. One patient had a myocardial infarction during the post-operative period. There were no other major complications within 30 days. The primary patency was 45.5% at 6 months and 22.7% at 12 months. Assisted primary patency was 68.1% at 6 months and 61.6% at 12 months, which was maintained up to 2 years. The secondary patency was 84.1% at 6 and 12 months. Conclusion: Our study shows that rotational thrombectomy device for single session thrombectomy of thrombosed arteriovenous fistulas and grafts is safe and effective. A high technical and clinical success rate was achieved, with low complication rates and specific advantages compared to other techniques, including reduced length of hospital stay. Our reported mid-term outcomes are reasonable with an assisted primary patency of 62% at 12 and 24 months. The use of newer techniques and novel dedicated thrombectomy devices show promise. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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