Ierardi Anna Maria, Carnevale Aldo, Coppola Andrea, Renzulli Matteo, Crippa Matteo, Fumarola Enrico Maria, Golfieri Rita, Giganti Melchiore, Carrafiello Gianpaolo
Diagnostic and Interventional Radiology Department, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy.
Department of Radiology, University Hospital of Ferrara, Ferrara, Italy.
J Vasc Access. 2020 Sep;21(5):738-745. doi: 10.1177/1129729820904911. Epub 2020 Feb 21.
The aim of this study was to investigate the effect of the time interval from clinical presentation of arteriovenous graft thrombosis and the thrombectomy procedure by the AngioJet system in terms of technical and clinical success and to identify factors influencing success.
A total of 60 consecutive patients (35 men and 25 women; mean age = 52 ± 7.89 years) who had undergone percutaneous thrombectomy by the AngioJet device from 2016 to 2019 were retrospectively enrolled. Demographics and fistula data, previous treatments, time from clinical onset of thrombosis to intervention, procedural details and complications were recorded. Technical and clinical success and primary and secondary patency rates were calculated. One-way analysis of variance was performed to test any correlation between patient-related and fistula/procedure-related variables and technical/clinical success. Odds ratio and relative risk were also calculated when necessary.
Technical success and clinical success were 95% and 91.7%, respectively. Post-interventional primary and secondary patency rates at 1 year were 72.5% and 84.3%, respectively. Complication rate was 6.7%. One-way analysis of variance showed that clinical success was higher in patients with no previous treatment (p = 0.015). Furthermore, clinical success was significantly associated with door to angiographic bed time (p = 0.002): p-value for the 24-h and the 72-h cut-off was 0.012 and 0.006, respectively.
Percutaneous rheolytic thrombectomy is safe and effective for thrombosed arteriovenous grafts, with acceptable primary and secondary patency rates. Higher clinical success was found in patients never treated before and when the procedure was carried out within 24 h from the clinical onset of thrombosis.
本研究旨在探讨动静脉移植物血栓形成临床表现至血管腔内血栓切除术（使用AngioJet系统）的时间间隔对技术和临床成功率的影响，并确定影响成功的因素。
回顾性纳入2016年至2019年期间使用AngioJet设备进行经皮血栓切除术的60例连续患者（35例男性和25例女性；平均年龄=52±7.89岁）。记录人口统计学和瘘管数据、既往治疗情况、从血栓形成临床发作到干预的时间、手术细节和并发症。计算技术和临床成功率以及初次和二次通畅率。进行单因素方差分析以检验患者相关和瘘管/手术相关变量与技术/临床成功率之间的任何相关性。必要时还计算比值比和相对风险。
技术成功率和临床成功率分别为95%和91.7%。干预后1年的初次和二次通畅率分别为72.5%和84.3%。并发症发生率为6.7%。单因素方差分析显示，既往未接受治疗的患者临床成功率更高（p = 0.015）。此外，临床成功率与从就诊到血管造影床时间显著相关（p = 0.002）：24小时和72小时截断值的p值分别为0.012和0.006。
经皮血栓溶解术治疗血栓形成的动静脉移植物安全有效，初次和二次通畅率可接受。从未接受过治疗的患者以及在血栓形成临床发作后24小时内进行手术时临床成功率更高。
