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A survival guide for endovascular declotting in dialysis access: procedures, devices, and a statistical analysis of

Panagiotis M Kitrou1, Konstantinos Katsanos1,2, Panagiotis Papadimatos1

  • 1a Department of Interventional Radiology , Patras University Hospital, School of Medicine , Rion , Greece.

Expert Review of Medical Devices
|March 17, 2018
PubMed

Insights

Thrombosis in vascular access is a major complication. A shift towards thrombectomy-dependent procedures and improved devices shows promise for better outcomes in treating thrombosed vascular access.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Nephrology

Background:

  • Thrombosis is a significant complication of vascular access.
  • Declotting procedures are categorized as thrombolysis-dependent or thrombectomy-dependent.

Purpose of the Study:

  • To systematically review and meta-analyze studies on percutaneous treatment of thrombosed vascular access published after 2001.
  • To investigate clinical success, postintervention assisted primary patency (PAPP), and influencing factors.

Main Methods:

  • Systematic review of 17 studies published after 2001.
  • Parametric meta-analysis of clinical data.

Main Results:

  • A trend towards thrombectomy-dependent procedures to reduce complications associated with thrombolytic agents.
  • Arteriovenous fistulas demonstrate superior PAPP.
  • Newer studies indicate non-significant improvements compared to older ones.
  • Advancements in angioplasty devices are crucial for declotting success.

Conclusions:

  • Thrombectomy-dependent procedures and improved angioplasty devices are key to enhancing outcomes in thrombosed vascular access.
  • Arteriovenous fistulas remain a favorable option for patency.
Abstract

Keywords:
Thrombectomyarteriovenous graftaspirationdeclottingfistulalyse and waitlysis-assisted balloon thrombectomymechanicalpharmaco-mechanicalpulse-spraythrombolysis

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