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Percutaneous Treatment of Failed Native Dialysis Fistulas: Use of Pulse-Spray Pharmacomechanical Thrombolysis as the Primary Mode of Therapy

OBJECTIVE: To determine the efficacy and outcome of percutaneous treatment in restoring the function of failed native arteriovenous fistulas (AVFs) where pulse-spray pharmacomechanical thrombolysis was used as the primary mode of therapy. MATERIALS AND METHODS: From June 2001 to July 2005, 14 patien...

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Autores principales: Cho, Sung Ki, Han, Heon, Kim, Sam Soo, Lee, Ji Yeon, Shin, Sung Wook, Do, Young Soo, Park, Kwang Bo, Choo, Sung Wook, Choo, In-Wook
Formato: Texto
Lenguaje:English
Publicado: The Korean Radiological Society 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667599/
https://www.ncbi.nlm.nih.gov/pubmed/16969047
http://dx.doi.org/10.3348/kjr.2006.7.3.180
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author Cho, Sung Ki
Han, Heon
Kim, Sam Soo
Lee, Ji Yeon
Shin, Sung Wook
Do, Young Soo
Park, Kwang Bo
Choo, Sung Wook
Choo, In-Wook
author_facet Cho, Sung Ki
Han, Heon
Kim, Sam Soo
Lee, Ji Yeon
Shin, Sung Wook
Do, Young Soo
Park, Kwang Bo
Choo, Sung Wook
Choo, In-Wook
author_sort Cho, Sung Ki
collection PubMed
description OBJECTIVE: To determine the efficacy and outcome of percutaneous treatment in restoring the function of failed native arteriovenous fistulas (AVFs) where pulse-spray pharmacomechanical thrombolysis was used as the primary mode of therapy. MATERIALS AND METHODS: From June 2001 to July 2005, 14 patients who had thrombosis of native AVFs underwent percutaneous restoration following 20 episodes of thrombosis. These included 6 repeated episodes in one forearm AVF and two episodes in another forearm AVF. All patients except one were treated with urokinase injection utilizing the pulse-spray technique and had subsequent balloon angioplasty. One patient was treated by percutaneous angioplasty alone. We retrospectively evaluated the feasibility of percutaneous treatment in restoring the function of the failed AVFs. The primary and secondary patencies were calculated by using a Kaplan-Meier analysis. RESULTS: Both technical and clinical success were achieved in 15 (75%) of 20 AVFs. Four of the five technical failures resulted from a failure to cross the occluded segment. One patient refused further participation in the trial through a brachial artery access following failure to cross the occluded segment via an initial retrograde venous puncture. There were no major precedure related complications observed. Including the initial technical failures, primary patency rates at six and 12 months were 64% and 55%, respectively. Secondary patency rates at six and 12 months were 71% and 63%, respectively. CONCLUSION: Pulse-spray pharmacomechanical thrombolysis for treatment of the thrombosed AVFs is safe, effective and durable. This procedure should be considered as an option for the management of failed AVFs prior to surgical intervention.
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spelling pubmed-26675992009-04-22 Percutaneous Treatment of Failed Native Dialysis Fistulas: Use of Pulse-Spray Pharmacomechanical Thrombolysis as the Primary Mode of Therapy Cho, Sung Ki Han, Heon Kim, Sam Soo Lee, Ji Yeon Shin, Sung Wook Do, Young Soo Park, Kwang Bo Choo, Sung Wook Choo, In-Wook Korean J Radiol Original Article OBJECTIVE: To determine the efficacy and outcome of percutaneous treatment in restoring the function of failed native arteriovenous fistulas (AVFs) where pulse-spray pharmacomechanical thrombolysis was used as the primary mode of therapy. MATERIALS AND METHODS: From June 2001 to July 2005, 14 patients who had thrombosis of native AVFs underwent percutaneous restoration following 20 episodes of thrombosis. These included 6 repeated episodes in one forearm AVF and two episodes in another forearm AVF. All patients except one were treated with urokinase injection utilizing the pulse-spray technique and had subsequent balloon angioplasty. One patient was treated by percutaneous angioplasty alone. We retrospectively evaluated the feasibility of percutaneous treatment in restoring the function of the failed AVFs. The primary and secondary patencies were calculated by using a Kaplan-Meier analysis. RESULTS: Both technical and clinical success were achieved in 15 (75%) of 20 AVFs. Four of the five technical failures resulted from a failure to cross the occluded segment. One patient refused further participation in the trial through a brachial artery access following failure to cross the occluded segment via an initial retrograde venous puncture. There were no major precedure related complications observed. Including the initial technical failures, primary patency rates at six and 12 months were 64% and 55%, respectively. Secondary patency rates at six and 12 months were 71% and 63%, respectively. CONCLUSION: Pulse-spray pharmacomechanical thrombolysis for treatment of the thrombosed AVFs is safe, effective and durable. This procedure should be considered as an option for the management of failed AVFs prior to surgical intervention. The Korean Radiological Society 2006 2006-09-30 /pmc/articles/PMC2667599/ /pubmed/16969047 http://dx.doi.org/10.3348/kjr.2006.7.3.180 Text en Copyright © 2006 The Korean Radiological Society http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Cho, Sung Ki
Han, Heon
Kim, Sam Soo
Lee, Ji Yeon
Shin, Sung Wook
Do, Young Soo
Park, Kwang Bo
Choo, Sung Wook
Choo, In-Wook
Percutaneous Treatment of Failed Native Dialysis Fistulas: Use of Pulse-Spray Pharmacomechanical Thrombolysis as the Primary Mode of Therapy
title Percutaneous Treatment of Failed Native Dialysis Fistulas: Use of Pulse-Spray Pharmacomechanical Thrombolysis as the Primary Mode of Therapy
title_full Percutaneous Treatment of Failed Native Dialysis Fistulas: Use of Pulse-Spray Pharmacomechanical Thrombolysis as the Primary Mode of Therapy
title_fullStr Percutaneous Treatment of Failed Native Dialysis Fistulas: Use of Pulse-Spray Pharmacomechanical Thrombolysis as the Primary Mode of Therapy
title_full_unstemmed Percutaneous Treatment of Failed Native Dialysis Fistulas: Use of Pulse-Spray Pharmacomechanical Thrombolysis as the Primary Mode of Therapy
title_short Percutaneous Treatment of Failed Native Dialysis Fistulas: Use of Pulse-Spray Pharmacomechanical Thrombolysis as the Primary Mode of Therapy
title_sort percutaneous treatment of failed native dialysis fistulas: use of pulse-spray pharmacomechanical thrombolysis as the primary mode of therapy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667599/
https://www.ncbi.nlm.nih.gov/pubmed/16969047
http://dx.doi.org/10.3348/kjr.2006.7.3.180
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