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Percutaneous management of acutely thrombosed hemodialysis grafts: The double balloon occlusion technique
Author(s) -
Lai ChiCheng,
Kang PeiLeun,
Tsai HanLin,
Mar GuangYuan,
Liu ChunPeng
Publication year - 2008
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.21808
Subject(s) - medicine , surgery , percutaneous , hematoma , balloon , thrombosis , occlusion , hemodialysis , radiology
Objectives: The aim of this article is to introduce a new technique, named the “double balloon occlusion technique” (DBOT), for the salvage of acutely thrombosed grafts and to demonstrate its safety and efficacy. Background: Acute thrombosis is recognized as the most common factor of acute graft failures. A suitably percutaneous technique should be devised to remove thrombi safely and effectively. Care should also be taken to prevent possible thromboembolic complications during procedures. Mainly composed of two balloons, the percutaneous DBOT has been developed to meet the clinical needs. Methods: Thirty‐two patients with graft failures undergoing the DBOT were recruited between May 2007 and May 2008. The DBOT is itemized in the text and a practical case undergoing successful DBOT is also demonstrated. Results: Of the 32 DBOT treatments, the procedural success rate was 100% (32/32). The clinical success rate was 94% (30/32). One complicated case with severe hematoma resulting from a balloon‐induced graft rupture received surgery, although the graft outflow restored. The mean procedure time was 92 minutes. Three patients died and two patients were lost within the 3‐month follow‐up. The 3‐month graft patency rate was 70% (19/27). Conclusion: The DBOT has the potential to be operated safely and effectively. Preliminary results had high success rates and patency rates. With basic devices, it may serve as an option to rescue thrombosed grafts. More data are needed to identify its clinical role. © 2008 Wiley‐Liss, Inc.