Hospital Alemão Oswaldo Cruz, Vascular and Endovascular Surgery, São Paulo, Brazil.
Hospital Alemão Oswaldo Cruz, Nephrology and Dialysis Center, São Paulo, Brazil.
J Vasc Access. 2024 Jan;25(1):113-118. doi: 10.1177/11297298221099469. Epub 2022 May 27.
The purpose of this study is to evaluate the safety and efficacy of the mechanical thrombectomy with the Indigo System in the treatment of thrombosed arteriovenous fistulas and grafts.
A retrospective search of endovascular procedures performed from November 2018 to June 2020 was conducted. Inclusion criteria were: acute arteriovenous fistula or graft thrombosis that underwent endovascular mechanical thrombectomy with Indigo System. The following information was collected from each case: sex, age, fistula modality, fistula location, treatment modality, and outcomes. Endpoints evaluated were: technical and clinical success rates; primary, assisted primary, and secondary patency rates; complication rates.
Twenty-six mechanical thrombectomy procedures for declotting of arteriovenous fistula thrombosis, using the Indigo System, were performed in 22 patients. Technical and clinical success was achieved in 23/26 cases (88%). Mean follow-up was 9 months (range 11-539 days). The 6-month primary, primary assisted, and secondary patency rates were 71%, 86%, 93% and the 12-month primary, primary assisted, and secondary patency rates were 71%, 72%, 80%, respectively. No technical or device-related complications were observed during thrombectomy, however two venous ruptures occurred on the angioplasty of the underlying stenosis.
In conclusion, vacuum-assisted thrombectomy of acutely thrombosed arteriovenous fistulas and grafts with Indigo System is safe and effective, providing good short term patency rates.
本研究旨在评估 Indigo 系统机械血栓切除术治疗血栓形成的动静脉瘘和移植物的安全性和疗效。
对 2018 年 11 月至 2020 年 6 月期间进行的血管内手术进行回顾性搜索。纳入标准为：接受 Indigo 系统血管内机械血栓切除术治疗的急性动静脉瘘或移植物血栓形成。从每个病例中收集以下信息：性别、年龄、瘘管方式、瘘管位置、治疗方式和结果。评估的终点包括：技术和临床成功率；原发性、辅助原发性和继发性通畅率；并发症发生率。
对 22 例患者的 26 例动静脉瘘血栓形成进行了 Indigo 系统机械血栓切除术，其中 23/26 例（88%）达到了技术和临床成功。平均随访时间为 9 个月（范围 11-539 天）。6 个月的原发性、原发性辅助性和继发性通畅率分别为 71%、86%、93%，12 个月的原发性、原发性辅助性和继发性通畅率分别为 71%、72%、80%。血栓切除术过程中未观察到技术或器械相关并发症，但在狭窄处的血管成形术中发生了两次静脉破裂。
总之，使用 Indigo 系统对急性血栓形成的动静脉瘘和移植物进行真空辅助血栓切除术是安全有效的，可提供良好的短期通畅率。
