PDF(Pubmed)
Abstract：
Arteriovenous grafts (AVGs) provide vascular access for hemodialysis in patients with end-stage renal disease (ESRD). However, vascular access thrombosis often occurs, requiring frequent reinterventions to maintain access patency. This report describes the successful use of the InThrill Thrombectomy System (Irvine, CA: Inari Medical) for macerating and removing thrombus from an occluded and heavily thrombosed AVG. A 47-year-old male was sent to our institute for a thrombosed right upper extremity arteriovenous access with a HeRO graft (South Jordan, UT: Merit Medical). The patient underwent interventions for the thrombosis of the same AVG two weeks prior using an Aspirex catheter (Franklin Lakes, NJ: BD Medical), and again two days prior with a Fogarty balloon catheter (Irvine, CA: Edwards Lifesciences). The patient presented with a recurrent completely occluded AVG. Using the InThrill Thrombectomy System and balloon angioplasty, the stenosis was reduced to less than 20%, resulting in brisk flow. The patient tolerated the procedure well without complication and recovered in the holding area with no acute distress. He was discharged the same day on anticoagulation therapy. This study highlights the successful use of the InThrill Thrombectomy System for the treatment of thrombosed AVG in a hemodialysis-dependent ESRD patient. The device was easy to use and efficient. Device and procedure times are unparalleled when compared with thrombolytic-based procedures. The patient\'s AVG remained patent at a 14-day follow-up.
摘要：
动静脉移植物（AVG）为终末期肾病（ESRD）患者的血液透析提供了血管通路。然而,经常发生血管通路血栓形成，需要频繁的再干预，以保持接入通畅。本报告描述了InThrill血栓切除术系统(Irvine，CA：InariMedical）用于从闭塞和严重血栓形成的AVG中浸渍和去除血栓。一名47岁的男性被送往我们的研究所接受血栓形成的右上肢动静脉通路，并进行了HeRO移植物（南约旦，UT：优点医疗）。在使用Aspirex导管（FranklinLakes，新泽西州：BDMedical），两天前用Fogarty球囊导管(Irvine，CA：爱德华兹生命科学）。患者出现复发性完全闭塞的AVG。使用InThrill血栓切除系统和球囊血管成形术，狭窄减少到20%以下，导致轻快的流动。患者对手术的耐受性良好，没有并发症，并且在保持区域恢复，没有急性困扰。他在抗凝治疗当天出院。这项研究强调了在血液透析依赖性ESRD患者中成功使用InThrill血栓切除术系统治疗血栓形成的AVG。该装置易于使用和高效。与基于溶栓的手术相比，设备和手术时间无与伦比。在14天的随访中，患者的AVG保持专利。
