Abstract：
OBJECTIVE: To evaluate the efficacy and outcome of the transjugular approach in endovascular recanalization of a thrombosed straight arteriovenous graft (AVG) compared to those of the direct hemodialysis access approach (conventional approach).
METHODS: We retrospectively assessed patients who underwent aspiration thrombectomy and percutaneous transluminal angioplasty for thrombosed straight AVG performed at a single institution between October 2006 and October 2021. A total of 138 thrombosed AVGs in 83 patients (39 male and 44 females) were divided into the transjugular approach group (Group A) and the conventional approach group (Group B). Technical and clinical success, postintervention primary patency, cumulative patency, and periprocedural complications were compared.
RESULTS: There was no statistical difference in demographic data between groups A and B. The technical success rate of group A and B was 96.4% (80/83) and 98.2% 54/55, respectively (p > 0.05). The mean procedure time was 61.4 min (Group A) and 70.5 min (Group B) (p > 0.05). There was no statistically significant difference between the two groups in postintervention primary patency. The cumulative patency of Groups A and B was 911.9 days (range 122-6277) and 1062.3 days (range 72-2302 days), respectively (p > 0.05). One patient in Group B experienced a major graft rupture. Pseudoaneurysm formation at the sheath insertion site occurred in two patients in Group B. No cases of stenosis or thrombosis of the IJV or hematoma at the puncture site were observed in Group A.
CONCLUSIONS: The transjugular approach is as safe and effective as the conventional approach for aspiration thrombectomy and percutaneous transluminal angioplasty of thrombosed straight AVGs.
METHODS: We retrospectively assessed patients who underwent aspiration thrombectomy and percutaneous transluminal angioplasty for thrombosed straight AVG performed at a single institution between October 2006 and October 2021. A total of 138 thrombosed AVGs in 83 patients (39 male and 44 females) were divided into the transjugular approach group (Group A) and the conventional approach group (Group B). Technical and clinical success, postintervention primary patency, cumulative patency, and periprocedural complications were compared.
RESULTS: There was no statistical difference in demographic data between groups A and B. The technical success rate of group A and B was 96.4% (80/83) and 98.2% 54/55, respectively (p > 0.05). The mean procedure time was 61.4 min (Group A) and 70.5 min (Group B) (p > 0.05). There was no statistically significant difference between the two groups in postintervention primary patency. The cumulative patency of Groups A and B was 911.9 days (range 122-6277) and 1062.3 days (range 72-2302 days), respectively (p > 0.05). One patient in Group B experienced a major graft rupture. Pseudoaneurysm formation at the sheath insertion site occurred in two patients in Group B. No cases of stenosis or thrombosis of the IJV or hematoma at the puncture site were observed in Group A.
CONCLUSIONS: The transjugular approach is as safe and effective as the conventional approach for aspiration thrombectomy and percutaneous transluminal angioplasty of thrombosed straight AVGs.
摘要：
目的：评估经颈静脉入路在血栓形成的直动静脉移植物（AVG）血管内再通中与直接血液透析入路（常规入路）的疗效和结果。
方法：我们回顾性评估了在2006年10月至2021年10月期间在一家机构接受了血栓形成的直AVG的抽吸血栓切除术和经皮腔内血管成形术的患者。83例患者(男39例,女44例)共138例,分为经颈静脉入路组(A组)和常规入路组(B组)。技术和临床成功，介入后原发性通畅，累积通畅，并比较围手术期并发症。
结果：A组和B组之间的人口统计学数据无统计学差异。A组和B组的技术成功率分别为96.4％（80/83）和98.2％54/55（p>0.05）。平均手术时间为61.4min(A组)和70.5min(B组)(p>0.05)。干预后两组患者的原发通畅率差异无统计学意义。A组和B组的累积通畅率为911.9天（范围122-6277）和1062.3天（范围72-2302天），分别为(p>0.05)。B组中的一名患者经历了严重的移植物破裂。B组2例患者在鞘管插入部位形成假性动脉瘤。A组未观察到IJV狭窄或血栓形成或穿刺部位血肿的病例。
结论：经颈静脉入路与常规方法一样安全有效，用于血栓形成的直AVG的血栓抽吸切除术和经皮腔内血管成形术。
方法：我们回顾性评估了在2006年10月至2021年10月期间在一家机构接受了血栓形成的直AVG的抽吸血栓切除术和经皮腔内血管成形术的患者。83例患者(男39例,女44例)共138例,分为经颈静脉入路组(A组)和常规入路组(B组)。技术和临床成功，介入后原发性通畅，累积通畅，并比较围手术期并发症。
结果：A组和B组之间的人口统计学数据无统计学差异。A组和B组的技术成功率分别为96.4％（80/83）和98.2％54/55（p>0.05）。平均手术时间为61.4min(A组)和70.5min(B组)(p>0.05)。干预后两组患者的原发通畅率差异无统计学意义。A组和B组的累积通畅率为911.9天（范围122-6277）和1062.3天（范围72-2302天），分别为(p>0.05)。B组中的一名患者经历了严重的移植物破裂。B组2例患者在鞘管插入部位形成假性动脉瘤。A组未观察到IJV狭窄或血栓形成或穿刺部位血肿的病例。
结论：经颈静脉入路与常规方法一样安全有效，用于血栓形成的直AVG的血栓抽吸切除术和经皮腔内血管成形术。
