J Korean Radiol Soc.  2004 Jul;51(1):45-53. 10.3348/jkrs.2004.51.1.45.

Usefulness of Thromboaspiration with Desilets-Hoffman Sheath in Thrombosed Hemodialysis Access Graft

• Goo DE
• Kim JH
• Park ST
• Chang YW
• Hwang JH
• Kwon KH
• Choi DL
• Mun C

• KMID: 2199780
• DOI: http://doi.org/10.3348/jkrs.2004.51.1.45

Abstract

PURPOSE: The purpose of this study was to evaluate the feasibility, efficacy and safety of percutaneous thromboaspiration with a Desilets-Hoffman Sheath compared with the previously established percutaneous mechanical thrombectomy technique in cases of occluded dialysis graft.
MATERIALS AND METHODS
One hundred and sixty eight patients (103 women, 65 men; mean age, 54.7 years; mean graft age, 20.9 months) with 225 episodes of dialysis graft thrombosis underwent percutaneous thromboaspiration with a 7F Desilets-Hoffman sheath using the crossing catheter or single puncture technique. The technical success rate, procedure time, and complication and patency rates were analyzed.
RESULTS
Technical success was achieved in 200 of the 225 procedures (88.9%). The average duration of the intervention was 74.3+/-35 minutes. The primary patency rate was 63.1% at 3 months, 44.2% at 6 months and 26.3% at 1 year. Major complications occurred in 4% of the cases (4 venous ruptures; 4 arterial embolisms; 1 arterial rupture) and minor complications occurred in 13.8% of the cases (26 minor venous ruptures; 4 intragraft ruptures; 1 venous dissection). These results were quite similar to those obtained with the previous mechanical thrombectomy technique.
CONCLUSION
Percutaneous thromboaspiration of occluded dialysis grafts with a Desilets-Hoffman Sheath is an effective and safe method.

Keyword

Dialysis ; Grafts, thrombosis ; Grafts, Interventional procedures ; Thrombectomy

MeSH Terms

Catheters
Dialysis
Embolism
Female
Humans
Male
Punctures
Renal Dialysis*
Rupture
Thrombectomy
Thrombosis
Transplants*