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Balloon Catheter Looping Technique for Entry Site Angioplasty During Endovascular Management of Thrombosed Arteriovenous Grafts by Single Access

Authors
 Sung Il Park  ;  Il Jung Kim  ;  Shin Jae Lee  ;  Man Deuk Kim  ;  Jong Yun Won  ;  Do Yun Lee  ;  Shin-Wook Kang  ;  Kyu Hun Choi 
Citation
 CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.37(2) : 502-507, 2014 
Journal Title
 CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 0174-1551 
Issue Date
2014
MeSH
Aged ; Aged, 80 and over ; Angioplasty, Balloon/methods* ; Animals ; Arteriovenous Shunt, Surgical/adverse effects* ; Cats ; Cohort Studies ; Endovascular Procedures/methods* ; Female ; Graft Occlusion, Vascular/diagnostic imaging ; Graft Occlusion, Vascular/etiology ; Graft Occlusion, Vascular/therapy* ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Radiography ; Renal Dialysis/adverse effects ; Renal Dialysis/methods ; Retrospective Studies ; Risk Assessment ; Thrombectomy/methods ; Thrombosis/diagnostic imaging ; Thrombosis/therapy ; Treatment Outcome ; Vascular Access Devices/adverse effects* ; Vascular Patency/physiology
Keywords
Dialysis shunts ; Grafts ; Thrombolysis ; Thrombectomy
Abstract
PURPOSE: This study was designed to evaluate the feasibility of balloon catheter looping technique for angioplasty of entry site lesions of stenosis or thrombi that could not be aspirated during endovascular treatment of thrombosed arteriovenous grafts by single access. METHODS: Balloon catheter looping technique was used for angioplasty of entry site lesions in 13 sessions of treatment of thrombosed arteriovenous grafts by single access in 11 patients (M:F = 7:4, mean age: 70.7 years, 9 brachio-axillary straight and 2 brachio-antecubital loop grafts) and were retrospectively evaluated. Middle equator of the graft was punctured and a 7F Desilets-Hoffman introducer sheath was inserted for aspiration thrombectomy and angioplasty. For entry site angioplasty, the balloon catheter was positioned 4-5 cm beyond the tip of the sheath. The sheath was retrieved to the entry site and was redirected into the contralateral limb, so the balloon catheter would form a loop. The introducer sheath was advanced to pull the balloon back to cover the entry site for angioplasty. Radiological images and medical records were evaluated for feasibility, success rate, and complications. RESULTS: Technical success of treatment of thrombosed graft and balloon catheter looping for entry site angioplasty could be achieved in all 13 cases (100%), without requiring second access. Completion fistulography revealed no access complication. Patency rate at 3 and 6 months were 80 and 68.6%, respectively. CONCLUSIONS: Balloon catheter looping technique for angioplasty of entry site lesions during endovascular treatment of thrombosed arteriovenous graft is a feasible alternative technique to obtaining a second access.
Full Text
http://link.springer.com/article/10.1007%2Fs00270-014-0847-8
DOI
10.1007/s00270-014-0847-8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Kim, Il Jung(김일중)
Park, Sung Il(박성일)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Do Yun(이도연)
Lee, Shin Jae(이신재)
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100351
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