J García-Medina1. 1. Vascular and Interventional Radiology Unit, Department of Radiology, Reina Sophia University Hospital, Calle Intendente Jorge Palacios 1, 30003, Murcia, Spain. josegmedina57@gmail.com.
Abstract
PURPOSE: To evaluate the value of duplex ultrasound assistance during thromboaspiration of thrombosed arteriovenous fistulae for haemodialysis. MATERIALS AND METHODS: We prospectively studied 54 thrombosed native fistulae (23 with total thrombosis and 31 with partial thrombosis), in which we performed manual thromboaspiration guided by ultrasonography associated with fluoroscopy. RESULTS: The fistulae were located in the forearm (n = 39) or in the upper arm (n = 15) of 46 patients. Mean patient age was 65 years, and hypertension was the most common risk factor (74 %). Mean access age was 928 days (range 69-2,290), and most fistulae were on the left side (41 cases, 75.92 %). The success rate was 83 % in the total thrombosis group and 100 % in the partial thrombosis group. Including initial failures, the respective primary patency rates in the total thrombosis group and the partial thrombosis group were, respectively, 83 ± 8 % (n = 20) and 87 ± 6 % (n = 28) at 1 month, 39 ± 10 % (n = 10) and 61 ± 8 % (n = 20) at 6 months, and 17 ± 8 % (n = 5) and 26 ± 8 % (n = 9) at 1 year. The mean decrease of fluoroscopy time with ultrasound was 3 min (range 1-5). The mean decrease of radiation dose was 2.6 Gy cm² (range 0.9-4.3]. CONCLUSION: Ultrasound is a feasible and useful tool in the management of thrombosed native fistulae, thus decreasing radiation exposure, and has no detrimental effect on success rates.
PURPOSE: To evaluate the value of duplex ultrasound assistance during thromboaspiration of thrombosed arteriovenous fistulae for haemodialysis. MATERIALS AND METHODS: We prospectively studied 54 thrombosed native fistulae (23 with total thrombosis and 31 with partial thrombosis), in which we performed manual thromboaspiration guided by ultrasonography associated with fluoroscopy. RESULTS: The fistulae were located in the forearm (n = 39) or in the upper arm (n = 15) of 46 patients. Mean patient age was 65 years, and hypertension was the most common risk factor (74 %). Mean access age was 928 days (range 69-2,290), and most fistulae were on the left side (41 cases, 75.92 %). The success rate was 83 % in the total thrombosis group and 100 % in the partial thrombosis group. Including initial failures, the respective primary patency rates in the total thrombosis group and the partial thrombosis group were, respectively, 83 ± 8 % (n = 20) and 87 ± 6 % (n = 28) at 1 month, 39 ± 10 % (n = 10) and 61 ± 8 % (n = 20) at 6 months, and 17 ± 8 % (n = 5) and 26 ± 8 % (n = 9) at 1 year. The mean decrease of fluoroscopy time with ultrasound was 3 min (range 1-5). The mean decrease of radiation dose was 2.6 Gy cm² (range 0.9-4.3]. CONCLUSION: Ultrasound is a feasible and useful tool in the management of thrombosed native fistulae, thus decreasing radiation exposure, and has no detrimental effect on success rates.
Authors: José García-Medina; Ana B Maldonado-Cárceles; Juan J García-Alfonso; Julián J Árense-Gonzalo; Alberto M Torres-Cantero Journal: Clin Kidney J Date: 2020-02-10