Treatment of thrombosed hemodialysis access grafts: Arrow-Trerotola percutaneous thrombolytic device versus pulse-spray thrombolysis. Arrow-Trerotola Percutaneous Thrombolytic Device Clinical Trial
| Autor: | K O Ehrman, G B Lund, Michael C. Soulen, John F. Cardella, Scott O. Trerotola, T M Vesely |
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| Rok vydání: | 1998 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous Time Factors medicine.medical_treatment Conscious Sedation Plasminogen Activators Renal Dialysis Fibrinolysis medicine Humans Radiology Nuclear Medicine and imaging Thrombolytic Therapy Prospective Studies Vascular Patency Proportional Hazards Models Thrombectomy Urokinase Intention-to-treat analysis business.industry Graft Occlusion Vascular Thrombosis Thrombolysis Equipment Design Middle Aged medicine.disease Urokinase-Type Plasminogen Activator Surgery Female Hemodialysis Complication business medicine.drug Follow-Up Studies |
| Zdroj: | Radiology. 206(2) |
| ISSN: | 0033-8419 |
| Popis: | To evaluate a percutaneous thrombolytic device (PTD) designed for treating thrombosed hemodialysis access grafts.To compare the PTD with pulse-spray pharmacomechanical thrombolysis (PSPMT) by using urokinase, 122 randomly chosen patients with synthetic, thrombosed hemodialysis access grafts from multiple centers prospectively underwent thrombolysis with the PTD (5-F, low-speed rotational mechanical device) or PSPMT. Major outcome variables included the procedure time, the immediate technical patency rate, the complication rate, and the 3-month patency rate.Sixty-four PTD and 58 PSPMT procedures were performed with intent to treat. The immediate technical patency rate was 95% (61 of 64 [PTD] and 55 of 58 [PSPMT]) in both procedures. Median procedure times were 75 minutes in the PTD group (range, 25-209 minutes) and 85 minutes in the PSPMT group (range, 50-273 minutes; P.04). Major complications occurred in 8% (five of 64) of PTD procedures (none related to the PTD) and 9% (five of 58) PSPMT procedures (not significant). Two devices broke (one during training) with no clinical sequela. The 3-month primary patency rate was 39% (25 of 64) in the PTD group and 40% (23 of 58) in the PSPMT group (not significant).The PTD is safe and effective for treating thrombosed hemodialysis access grafts. The technical and long-term success rates are similar to those of PSPMT; procedure times are shorter. |
| Databáze: | OpenAIRE |
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