The aim of this prospectively collected case series is to demonstrate a novel technique of using the ClariVein® catheter for pharmacomechanical thrombolysis of thrombosed hemodialysis grafts.
The analysis comprised 11 procedures in 9 patients from 1 July to 31 December 2016 in which the ClariVein catheter was used in combination with urokinase. Demographic data, procedural data, technical and clinical success rates, and complications were evaluated. The primary and secondary patency rates at 1 and 3 months were also analyzed.
In the 11 procedures performed, the technical and clinical success was 100%. The mean procedural time was 66.8 minutes (range 50-90 minutes), and the mean amount of urokinase administered was 87,000 units. The primary unassisted patency rates at 1 and 3 months were 81.8% and 63.6%, respectively. The secondary patency rates at 1 and 3 months were 90.9% and 81.8%, respectively. Perforation occurred after balloon angioplasty in 1 (9.1%) of the 11 procedures, for which covered stenting was performed. No major complications occurred.
The combination use of the ClariVein catheter with urokinase for pharmacomechanical thrombolysis in thrombosed hemodialysis grafts is a feasible and safe method that can be performed in a relatively short duration. Our early results have shown 100% technical and clinical success. This case series serves as a platform for an upcoming prospective study to further evaluate this method.
J Vasc Access 2017; 18(6): 508 - 514
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsDarryl Lim, Derek C. Ho, Lionel Chen, Michiel A. Schreve, Yih Kai Tan, Steven Kum
- • Accepted on 19/05/2017
- • Available online on 27/07/2017
- • Published in print on 17/11/2017
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- Lim, Darryl [PubMed] [Google Scholar] 1, * Corresponding Author (email@example.com)
- Ho, Derek C. [PubMed] [Google Scholar] 1
- Chen, Lionel [PubMed] [Google Scholar] 1
- Schreve, Michiel A. [PubMed] [Google Scholar] 2
- Tan, Yih Kai [PubMed] [Google Scholar] 1
- Kum, Steven [PubMed] [Google Scholar] 1
Vascular Service, Department of Surgery, Changi General Hospital, Singapore - Singapore
Department of Surgery, Noordwest Ziekenhuisgroep, Alkmaar - The Netherlands