Retrospective study of vacuum aspiration mechanical thrombectomy device in the treatment of arteriovenous fistula thrombosis and patient is on hemodialysis

Abstract

Objective:

To evaluate the use of the device of mechanical thrombectomy aspiration in the salvage of the fistula for hemodialysis access (HD) with acute thrombosis.

Method:

The study model used was a retrospective cohort in which 35 patients, who underwent 44 percutaneus thrombectomy in a tertiary hospital between October 2018 and March 2020, were evaluated. The surgical time of the thrombectomy, the technical success (TS) and the clinical success (CS) were evaluated, as well as the occurrence of surgical complications. Additional adjunct therapy, such balloon angioplasty or thrombolytic therapy when performed was not evaluated.

Results:

Among the 35 evaluated patients, 24 (66.8%) were male. In 33 of these cases (75%), the fistula used an autologous vein (AV fistula). The average thrombectomy time was 20.2 min and median was 15 min, with a difference between the AV fistula and synthetic graft (Graft) (p = 0.001), being shorter in the Graft. The TS rate was of 86.4% and the CS rate was of 84.1% with no statistical difference between the groups. The rate of surgical complications was of 13.6%. Blood loss in most cases ranged from 100 to 300 ml in the majority of the cases.

Conclusion:

The Device showed a short operation time in its use, a high rate of technical success and clinical success, as well as a similar rate of immediate surgical complications found in the literature.