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Endovascular Recanalization of a Thrombosed Native Arteriovenous Fistula Complicated with an Aneurysm: Technical Aspects and Outcomes

OBJECTIVE: To evaluate the technical aspects and outcomes of endovascular recanalization of a thrombosed native arteriovenous fistula (AVF) complicated with an aneurysm. MATERIALS AND METHODS: Sixteen patients who had a thrombosed AVF complicated with an aneurysm (two radiocephalic and 14 brachiocep...

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Autores principales: Ahn, Su Yeon, So, Young Ho, Choi, Young Ho, Jung, In Mok, Chung, Jung Kee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Radiology 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347271/
https://www.ncbi.nlm.nih.gov/pubmed/25741197
http://dx.doi.org/10.3348/kjr.2015.16.2.349
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author Ahn, Su Yeon
So, Young Ho
Choi, Young Ho
Jung, In Mok
Chung, Jung Kee
author_facet Ahn, Su Yeon
So, Young Ho
Choi, Young Ho
Jung, In Mok
Chung, Jung Kee
author_sort Ahn, Su Yeon
collection PubMed
description OBJECTIVE: To evaluate the technical aspects and outcomes of endovascular recanalization of a thrombosed native arteriovenous fistula (AVF) complicated with an aneurysm. MATERIALS AND METHODS: Sixteen patients who had a thrombosed AVF complicated with an aneurysm (two radiocephalic and 14 brachiocephalic) were included in this study. Recanalization procedures were performed by mechanical thrombectomy using the Arrow-Trerotola percutaneous thrombectomy device and adjunctive treatments. We evaluated dose of thrombolytic agent, underlying stenosis, procedure time, technical and clinical success, and complications. The primary and secondary patency rates were calculated using the Kaplan-Meier analysis. RESULTS: The thrombolytic agents used were 100000 U urokinase mixed with 500 IU heparin (n = 10) or a double dose of the mixture (n = 6). The thrombi in aneurysms were removed in all but two patients with non-flow limiting residual thrombi. One recanalization failure occurred due to a device failure. Aspiration thrombectomy was performed in 87.5% of cases (n = 14). Underlying stenoses were found in the outflow draining vein (n = 16), arteriovenous anastomosis or juxtaanastomosis area (n = 5), and the central vein (n = 3). Balloon angioplasty was performed for all stenoses in 15 patients. Two patients with a symptomatic central vein stenosis underwent insertion of a stent after balloon angioplasty. Mean procedure time was 116.3 minutes. Minor extravasation (n = 1) was resolved by manual compression. Both technical and clinical success rates were 93.8% (n = 15). The primary patency rates at 3, 6, and 12 months were 70.5%, 54.8%, and 31.3%, respectively. The secondary patency rates at 3, 6, and 12 months were 70.5%, 70.5%, and 47.0%, respectively. CONCLUSION: Thrombosed AVF complicated with an aneurysm can be successfully recanalized, and secondary patency can be prolonged with endovascular treatment.
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spelling pubmed-43472712015-03-04 Endovascular Recanalization of a Thrombosed Native Arteriovenous Fistula Complicated with an Aneurysm: Technical Aspects and Outcomes Ahn, Su Yeon So, Young Ho Choi, Young Ho Jung, In Mok Chung, Jung Kee Korean J Radiol Intervention OBJECTIVE: To evaluate the technical aspects and outcomes of endovascular recanalization of a thrombosed native arteriovenous fistula (AVF) complicated with an aneurysm. MATERIALS AND METHODS: Sixteen patients who had a thrombosed AVF complicated with an aneurysm (two radiocephalic and 14 brachiocephalic) were included in this study. Recanalization procedures were performed by mechanical thrombectomy using the Arrow-Trerotola percutaneous thrombectomy device and adjunctive treatments. We evaluated dose of thrombolytic agent, underlying stenosis, procedure time, technical and clinical success, and complications. The primary and secondary patency rates were calculated using the Kaplan-Meier analysis. RESULTS: The thrombolytic agents used were 100000 U urokinase mixed with 500 IU heparin (n = 10) or a double dose of the mixture (n = 6). The thrombi in aneurysms were removed in all but two patients with non-flow limiting residual thrombi. One recanalization failure occurred due to a device failure. Aspiration thrombectomy was performed in 87.5% of cases (n = 14). Underlying stenoses were found in the outflow draining vein (n = 16), arteriovenous anastomosis or juxtaanastomosis area (n = 5), and the central vein (n = 3). Balloon angioplasty was performed for all stenoses in 15 patients. Two patients with a symptomatic central vein stenosis underwent insertion of a stent after balloon angioplasty. Mean procedure time was 116.3 minutes. Minor extravasation (n = 1) was resolved by manual compression. Both technical and clinical success rates were 93.8% (n = 15). The primary patency rates at 3, 6, and 12 months were 70.5%, 54.8%, and 31.3%, respectively. The secondary patency rates at 3, 6, and 12 months were 70.5%, 70.5%, and 47.0%, respectively. CONCLUSION: Thrombosed AVF complicated with an aneurysm can be successfully recanalized, and secondary patency can be prolonged with endovascular treatment. The Korean Society of Radiology 2015 2015-02-27 /pmc/articles/PMC4347271/ /pubmed/25741197 http://dx.doi.org/10.3348/kjr.2015.16.2.349 Text en Copyright © 2015 The Korean Society of Radiology 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 Intervention
Ahn, Su Yeon
So, Young Ho
Choi, Young Ho
Jung, In Mok
Chung, Jung Kee
Endovascular Recanalization of a Thrombosed Native Arteriovenous Fistula Complicated with an Aneurysm: Technical Aspects and Outcomes
title Endovascular Recanalization of a Thrombosed Native Arteriovenous Fistula Complicated with an Aneurysm: Technical Aspects and Outcomes
title_full Endovascular Recanalization of a Thrombosed Native Arteriovenous Fistula Complicated with an Aneurysm: Technical Aspects and Outcomes
title_fullStr Endovascular Recanalization of a Thrombosed Native Arteriovenous Fistula Complicated with an Aneurysm: Technical Aspects and Outcomes
title_full_unstemmed Endovascular Recanalization of a Thrombosed Native Arteriovenous Fistula Complicated with an Aneurysm: Technical Aspects and Outcomes
title_short Endovascular Recanalization of a Thrombosed Native Arteriovenous Fistula Complicated with an Aneurysm: Technical Aspects and Outcomes
title_sort endovascular recanalization of a thrombosed native arteriovenous fistula complicated with an aneurysm: technical aspects and outcomes
topic Intervention
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347271/
https://www.ncbi.nlm.nih.gov/pubmed/25741197
http://dx.doi.org/10.3348/kjr.2015.16.2.349
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