Vacuum-assisted mechanical thrombectomy in extensively occlusive thrombosis of dialysis arteriovenous grafts with indigo system. Issue 5 (September 2020)

• Record Type: Journal Article
• Authors: Piacentino, Filippo; Coppola, Andrea; Zaghetto, Andrea; Macchi, Edoardo; De Marchi, Giuseppe; Ossola, Christian; Zorzetto, Giada; Beneventi, Alessandro; Casamassima, Nicola; Tagliaferri, Chiara; Tozzi, Matteo; Piffaretti, Gabriele; Fontana, Federico; Genovese, Eugenio Annibale
• Is Part Of: Journal of vascular access. Volume 21:Issue 5(2020)
• Page Start: 673
• Page End: 679
• Publication Date: 2020-09
• Subjects: Prosthetic grafts -- dialysis access -- new devices -- interventional radiology -- techniques and procedures -- biomaterials; Arterial catheterization -- Periodicals; Intravenous catheterization -- Periodicals; 612.13
• DOI: 10.1177/1129729819899264
• Languages: English
• ISSNs: 1129-7298

Abstract

Purpose: To present a selected series of extensively occlusive thrombosis of arteriovenous graft treated with the Penumbra's Indigo System. Materials and Methods: Ten patients with acute (within 72 h) extensively occlusive thrombosis of arteriovenous graft (mean extension = 30.1 (range = 15–45) cm) were treated at our institution with the Indigo System. Of the 10 cases, thrombosis was extended to venous outflow in 7 cases and to both arterial inflow and venous outflow in 3 cases. Results: Both anatomic and clinical success were achieved in 8 of the 10 procedures (80.0%). In the 2 cases of technical failure, the patients underwent surgical thrombectomy with the finding of arteriovenous graft exhaustion, which was then replaced. The 6-month primary patency, primary-assisted patency, and secondary patency rates were 37.5% (3/8), 50.0% (4/8), and 62.5% (5/8). We reported 2 complications (one minor and one major adverse event). Conclusion: Percutaneous mechanical thrombectomy aspiration with Indigo System is a relatively safe and effective procedure and can be used even in extensively thrombosed arteriovenous graft.