AngioJet thrombectomy to salvage thrombosed native dialysis fistulas

Abstract

Purpose: To investigate outcomes following treatment of thrombosed native dialysis fistulas with AngioJet thrombectomy. Materials and Methods: We retrospectively reviewed an existing database and included patients according to the following criteria: thrombosed fistula, native fistula, and use of the AngioJet system for mechanical thrombectomy. Outcomes included clinical success, complications, and patency rates. Results: One hundred and nine patients with 135 episodes of native fistula thrombosis were included in the study. Clinical success was achieved in 76% (103 of 135) of the procedures. Fistulas salvaged within three days of thrombosis had higher clinical success rates than those salvaged after three days (80% vs. 63%). The average procedure time was 82 ± 37 minutes. Complications occurred in 15% (20 of 135) of the procedures, but all were not device-related. The primary patency rates were 67%, 57%, and 39% and the secondary patency rates were 74%, 72%, and 70% at 30, 90, and 180 days, respectively. In the Cox regression analysis, only diabetes mellitus, current smoker, right-sided fistula and small vessel size were independent predictors of primary patency. Conclusion: Percutaneous thrombectomy using the AngioJet system is effective for the salvage of thrombosed native dialysis fistulas. It has an acceptable complication rate, primary patency rate, and secondary patency rate.