https://scholars.lib.ntu.edu.tw/handle/123456789/475472
Title: | Treating thrombotic prosthetic arteriovenous access with cross-balloon occlusive thrombolysis and angioplasty | Authors: | Sun, Shen HENG-WEN CHOU Chen, Jer-Shen CHIH-YANG CHAN |
Issue Date: | 2012 | Publisher: | Elsevier (Singapore) Pte Ltd | Journal Volume: | 35 | Journal Issue: | 2 | Start page/Pages: | 88-92 | Source: | Asian Journal of Surgery | Abstract: | Objective: Clot embolism remains a concern due to flushing of clot and thrombolytic agent centrally in the process of percutaneous pharmacomechanical thrombolysis (PMT) for a thrombosed prosthetic arteriovenous access (PAVA), which might be reduced by a modified technique. Methods: We retrospectively review this modified technique that uses two balloon-catheters in crisscross fashion and occludes both ends of PAVA during thrombolysis. Underlying stenotic lesions were dilated simultaneously with balloon angioplasty when needed. Results: Among the 23 patients treated, 21 (91.3%), 10 (43.5%), and seven (30.4%) presented significant stenosis at the outflow, intragraft, and inflow segments of PAVA, respectively. The median duration of follow-up was 310.0 (range, 288.0-327.0) days. Anatomic success was achieved in 12 out of 23 (52.2%). Clinical success for successful dialysis was achieved in all patients. The median primary patency and secondary patency were 126.0 days (range, 7.0-316.0) days and 308.0 days (range, 84.0-327.0), respectively. Conclusion: We believe this method is safe and effective in dissolving PAVA thrombus as well as treating culprit stenosis. It may reduce concerns of flushing of clot and thrombolytic agent into the central circulation in the process of PMT. © 2012, Asian Surgical Association. Published by Elsevier Taiwan LLC. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84862702850&doi=10.1016%2fj.asjsur.2012.04.016&partnerID=40&md5=2e272927baaed4536de7bf933e5b1d4d https://scholars.lib.ntu.edu.tw/handle/123456789/475472 |
ISSN: | 1015-9584 | DOI: | 10.1016/j.asjsur.2012.04.016 |
Appears in Collections: | 醫學系 |
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