A survival guide for endovascular declotting in dialysis access: procedures, devices, and a statistical analysis of 3,000 cases

作者：Kitrou Panagiotis M; Katsanos Konstantinos; Papadimatos Panagiotis; Spiliopoulos Stavros; Karnabatidis Dimitris

来源：Expert Review of Medical Devices, 2018, 15(4): 283-291.

DOI：10.1080/17434440.2018.1454311

• Thrombectomy
• thrombolysis
• declotting
• arteriovenous graft
• fistula
• lyse and wait
• pulse-spray
• lysis-assisted balloon thrombectomy
• mechanical
• aspiration
• pharmaco-mechanical

Introduction: Thrombosis is the most important access-related complication. Several declotting procedures have been suggested falling mainly into two categories; thrombolysis-dependent and thrombectomy-dependent.Areas covered: Seventeen studies after 2001 have been published on percutaneous treatment of thrombosed vascular access. Authors performed a systematic review of these studies together with a parametric meta-analysis of data available investigating clinical success, postintervention assisted primary patency (PAPP) and independent factors that could influence outcome measures.Expert commentary: A shift to thrombectomy-dependent procedures is observed with a view to diminishing complications from the use of thrombolytic agents. Arteriovenous fistulas provide significantly better PAPP, while newer studies show improved, non-significant results compared with older ones. The role of improvement of devices for subsequent angioplasty is of equal importance, if not more, for improved declotting results.

• 出版日期2018