Usefulness of Thromboaspiration with Desilets-Hoffman Sheath in Thrombosed Hemodialysis Access Graft

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the feasibility, efficacy and safety of percutaneous thromboaspiration with a Desilets-Hoffman Sheath compared with the previously established percutaneous mechanical thrombectomy technique in cases of occluded dialysis graft. MATERIALS AND METHODS: One hundred and sixty eight patients (103 women, 65 men; mean age, 54.7 years; mean graft age, 20.9 months) with 225 episodes of dialysis graft thrombosis underwent percutaneous thromboaspiration with a 7F Desilets-Hoffman sheath using the crossing catheter or single puncture technique. The technical success rate, procedure time, and complication and patency rates were analyzed. RESULTS:Technical success was achieved in 200 of the 225 procedures (88.9%). The average duration of the intervention was 74.3+/-35 minutes. The primary patency rate was 63.1% at 3 months, 44.2% at 6 months and 26.3% at 1 year. Major complications occurred in 4% of the cases (4 venous ruptures; 4 arterial embolisms; 1 arterial rupture) and minor complications occurred in 13.8% of the cases (26 minor venous ruptures; 4 intragraft ruptures; 1 venous dissection). These results were quite similar to those obtained with the previous mechanical thrombectomy technique. CONCLUSION: Percutaneous thromboaspiration of occluded dialysis grafts with a Desilets-Hoffman Sheath is an effective and safe method.