Chan Philip Gc, Goh Gerard S
1 Department of Radiology, The Alfred Hospital, Melbourne, VIC, Australia.
2 Department of Surgery, Central Clinical School, Monash University, Melbourne, VIC, Australia.
J Vasc Access. 2018 May;19(3):243-251. doi: 10.1177/1129729818760977. Epub 2018 Mar 16.
The AngioJet Hemolytic Thrombectomy Device "AngioJet" (Boston Scientific, Malborough, MA, USA) is a rheolytic thrombectomy device that can be used in the treatment of hemodialysis arteriovenous fistula and graft thrombosis. We aim to appraise the current evidence on AngioJet thrombectomy in hemodialysis vascular access thrombosis, and to determine its safety, including complications and efficacy.
An electronic literature search was performed on the MEDLINE and Embase databases. References of retrieved articles were also reviewed. Articles using AngioJet for the treatment of arteriovenous fistula or graft were included. Patients less than 18 years old, non-English articles, single case reports, small case series (<5 cases), conference publications, and nonhuman models were excluded.
A total of 688 articles were initially evaluated and 10 articles fulfilled the inclusion criteria, which included 836 patients with 431 grafts and 234 fistulas. Results were heterogeneously reported. The adjusted mean primary patency rates for 1, 3, 6, and 12 months were 64.6%, 43.8%, 42.5%, and 30.5%, respectively; adjusted mean secondary patency rates for 3, 6, and 12 months were 76.5%, 75.1%, and 74.5%, and assisted primary patency rates were 61.9%, 47.3%, and 35.3%, respectively. There were 126 complications, most were minor. There were seven deaths, but were unable to be attributable to the AngioJet.
The AngioJet is an effective and safe treatment option for thrombosed fistulas and grafts. However, the quality of the current evidence is poor. Further research with prospective randomized controlled trials using standardized data reporting methods is needed to prove its safety and efficacy.
AngioJet溶血栓切除术装置（美国马萨诸塞州马尔伯勒市波士顿科学公司生产）是一种用于治疗血液透析动静脉内瘘和移植物血栓形成的流变血栓切除术装置。我们旨在评估当前关于AngioJet血栓切除术治疗血液透析血管通路血栓形成的证据，并确定其安全性，包括并发症和疗效。
在MEDLINE和Embase数据库中进行电子文献检索。还对检索到的文章的参考文献进行了审查。纳入使用AngioJet治疗动静脉内瘘或移植物的文章。排除18岁以下患者、非英文文章、单病例报告、小病例系列（<5例）、会议出版物和非人类模型。
最初共评估了688篇文章，10篇符合纳入标准，其中包括836例患者，431个移植物和234个内瘘。结果报告存在异质性。1个月、3个月、6个月和12个月的调整后平均初次通畅率分别为64.6%、43.8%、42.5%和30.5%；3个月、6个月和12个月的调整后平均二次通畅率分别为76.5%、75.1%和74.5%，辅助初次通畅率分别为61.9%、47.3%和35.3%。共有126例并发症，大多数为轻微并发症。有7例死亡，但无法归因于AngioJet。
AngioJet是治疗血栓形成的内瘘和移植物的一种有效且安全的治疗选择。然而，当前证据的质量较差。需要使用标准化数据报告方法进行前瞻性随机对照试验的进一步研究，以证明其安全性和疗效。
