Hybrid simultaneous treatment of thrombosed prosthetic grafts for hemodialysis
Hybrid simultaneous treatment of thrombosed prosthetic grafts for hemodialysis
Post author correction
Article Type: ORIGINAL ARTICLE
DOI:10.5301/jva.5000218
Authors
Nicola Troisi, Emiliano Chisci, Pierfrancesco Frosini, Eugenio Romano, Marco Setti, Giulio Mingardi, Stefano Michelagnoli
Corresponding author
- Nicola Troisi
- Department of Surgery Vascular and Endovascular Surgery Unit San Giovanni di Dio Hospital
- Via di Torregalli 3 50143 Florence, Italy
Abstract
The aim of the study was to evaluate our experience in the hybrid simultaneous treatment (open and endovascular) of acute thrombosis of prosthetic grafts for hemodialysis.
Between January 2011 and June 2013, 23 patients with acute thrombosis of a prosthetic graft for hemodialysis were urgently treated with a hybrid simultaneous treatment in order to obtain a prompt restoration of the flow. A new puncture of the graft was scheduled after 24 hours.
Intraoperative technical success was 100% with a completion angiography showing the restored patency of the graft. As adjunctive procedures, in 6 patients (26.1%) locoregional thrombolysis was necessary and in all cases further endovascular manoeuvres (angioplasty/stenting) were immediately performed to solve a significant stenosis of the venous anastomosis/first tract of the vein. At 24 hours when the first puncture was done, three grafts were occluded resulting in a primary patency of 87%. During the follow-up (mean duration 5.6 months) four reocclusions occurred. In-stent restenosis occurred in all patients undergone stenting. At 1 year the rates of primary patency, primary assisted patency and secondary patency were 58.7%, 78.3% and 87%, respectively.
In our series the combined simultaneous hybrid approach in urgency maximizes the use of different available techniques, which appeared to improve overall success rate to save a thrombosed graft for hemodialysis. The great difference showed between primary and primary assisted patency demonstrates the necessity of a close follow-up.
Article History
- • Accepted on 12/01/2014
- • Available online on 05/04/2014
Disclosures
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Authors
- Troisi, Nicola [PubMed] [Google Scholar] 1, 2, * Corresponding Author
- Chisci, Emiliano [PubMed] [Google Scholar] 1
- Frosini, Pierfrancesco [PubMed] [Google Scholar] 1
- Romano, Eugenio [PubMed] [Google Scholar] 1
- Setti, Marco [PubMed] [Google Scholar] 2
- Mingardi, Giulio [PubMed] [Google Scholar] 3
- Michelagnoli, Stefano [PubMed] [Google Scholar] 1
- Address for correspondence:
- Department of Surgery Vascular and Endovascular Surgery Unit San Giovanni di Dio Hospital
- Via di Torregalli 3 50143 Florence, Italy
- nicola.troisi@alice.it
Affiliations
- Department of Surgery, Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence - Italy
- Department of Cardiovascular Disease, Section of Vascular Surgery, Cliniche Humanitas Gavazzeni, Bergamo - Italy
- Department of Medicine, Section of Nephrology, Cliniche Humanitas Gavazzeni, Bergamo - Italy