Dialysis grafts arterial plug : Retrieval using the tulip sheath device in vitro
The "arterial plug" is a resistant thrombus that frequently persists at the arterial anastomosis of clotted hemodialysis grafts following thrombolytic therapy. We studied the physical and morphological characteristics of the plug and determined the feasibility of transcatheter removal in v...
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| Veröffentlicht in: | Cardiovascular and interventional radiology 1997-03, Vol.20 (2), p.154-158 |
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| description | The "arterial plug" is a resistant thrombus that frequently persists at the arterial anastomosis of clotted hemodialysis grafts following thrombolytic therapy. We studied the physical and morphological characteristics of the plug and determined the feasibility of transcatheter removal in vitro using the tulip compression thrombectomy system. Sixteen thrombus plugs were recovered during surgical thrombectomy of clotted human dialysis grafts. The physical and gross physical characteristics of all plugs were analyzed. Eight specimens were evaluated microscopically. Transcatheter compression thrombectomy of eight plugs was attempted in vitro. Each plug was embedded in a polyvinyl tube filled with newly clotted blood and connected to a flow circuit. First, balloon-assisted aspiration thrombectomy (BAT) of soft thrombus was performed, while sparing the distal-most segment containing the plug. The tulip sheath was then introduced facing the "arterial end" of the tube. The thrombus segment containing the plug was pulled back into the tulip mesh using either a 3 Fr Fogarty balloon catheter or a self-expanding rake. The tulip was closed to compress and remove the trapped plug. Near-complete thrombectomy of soft clot was achieved in all tested tubes. Compression and retrieval of the entire arterial plug was successful in all except one, where only partial compression of the plug occurred, presumably due to fibrotic changes. No fragmentation or embolization occurred in the remaining procedures. Spongy consistency was noted in 94% of the specimens. Microscopic evaluation showed organized layered thrombus with compaction in five plugs. Transcatheter removal of a thrombus plug is feasible in vitro using the tulip compression-thrombectomy system. |
| doi_str_mv | 10.1007/s002709900126 |
| format | Article |
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J ; TITUS, J. L ; GU, X ; HUNTER, D. W ; AMPLATZ, K</creator><creatorcontrib>SHARAFUDDIN, M. J ; TITUS, J. L ; GU, X ; HUNTER, D. W ; AMPLATZ, K</creatorcontrib><description>The "arterial plug" is a resistant thrombus that frequently persists at the arterial anastomosis of clotted hemodialysis grafts following thrombolytic therapy. We studied the physical and morphological characteristics of the plug and determined the feasibility of transcatheter removal in vitro using the tulip compression thrombectomy system. Sixteen thrombus plugs were recovered during surgical thrombectomy of clotted human dialysis grafts. The physical and gross physical characteristics of all plugs were analyzed. Eight specimens were evaluated microscopically. Transcatheter compression thrombectomy of eight plugs was attempted in vitro. Each plug was embedded in a polyvinyl tube filled with newly clotted blood and connected to a flow circuit. First, balloon-assisted aspiration thrombectomy (BAT) of soft thrombus was performed, while sparing the distal-most segment containing the plug. The tulip sheath was then introduced facing the "arterial end" of the tube. The thrombus segment containing the plug was pulled back into the tulip mesh using either a 3 Fr Fogarty balloon catheter or a self-expanding rake. The tulip was closed to compress and remove the trapped plug. Near-complete thrombectomy of soft clot was achieved in all tested tubes. Compression and retrieval of the entire arterial plug was successful in all except one, where only partial compression of the plug occurred, presumably due to fibrotic changes. No fragmentation or embolization occurred in the remaining procedures. Spongy consistency was noted in 94% of the specimens. Microscopic evaluation showed organized layered thrombus with compaction in five plugs. Transcatheter removal of a thrombus plug is feasible in vitro using the tulip compression-thrombectomy system.</description><identifier>ISSN: 0174-1551</identifier><identifier>EISSN: 1432-086X</identifier><identifier>DOI: 10.1007/s002709900126</identifier><identifier>PMID: 9030510</identifier><identifier>CODEN: CAIRDG</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Anastomosis ; Arteriovenous Shunt, Surgical ; Balloon catheters ; Balloon treatment ; Biological and medical sciences ; BLOOD ; Blood clots ; Catheterization - instrumentation ; Catheterization - methods ; Catheters ; Circuits ; CLOSURES ; Compression ; DIALYSIS ; Diseases of the cardiovascular system ; Embolization ; Feasibility ; Graft Occlusion, Vascular - therapy ; Grafting ; GRAFTS ; Hemodialysis ; Humans ; IN VITRO ; Medical instruments ; Medical sciences ; Models, Structural ; Physical characteristics ; Physical properties ; Plugs ; RADIOLOGY AND NUCLEAR MEDICINE ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Renal Dialysis ; Retrieval ; Segments ; Sheaths ; SURGERY ; THERAPY ; Thrombectomy - instrumentation ; Thrombectomy - methods ; Thrombolysis ; Thrombosis ; Thrombosis - therapy ; Tubes ; Tulipa ; VASCULAR DISEASES</subject><ispartof>Cardiovascular and interventional radiology, 1997-03, Vol.20 (2), p.154-158</ispartof><rights>1997 INIST-CNRS</rights><rights>Springer-Verlag New York Inc 1997.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-e97bb80fcfab87a15037067168250afd7540ab609cb4962233c2abc93dfb91b3</citedby><cites>FETCH-LOGICAL-c372t-e97bb80fcfab87a15037067168250afd7540ab609cb4962233c2abc93dfb91b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2630148$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9030510$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/21080226$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>SHARAFUDDIN, M. J</creatorcontrib><creatorcontrib>TITUS, J. L</creatorcontrib><creatorcontrib>GU, X</creatorcontrib><creatorcontrib>HUNTER, D. W</creatorcontrib><creatorcontrib>AMPLATZ, K</creatorcontrib><title>Dialysis grafts arterial plug : Retrieval using the tulip sheath device in vitro</title><title>Cardiovascular and interventional radiology</title><addtitle>Cardiovasc Intervent Radiol</addtitle><description>The "arterial plug" is a resistant thrombus that frequently persists at the arterial anastomosis of clotted hemodialysis grafts following thrombolytic therapy. We studied the physical and morphological characteristics of the plug and determined the feasibility of transcatheter removal in vitro using the tulip compression thrombectomy system. Sixteen thrombus plugs were recovered during surgical thrombectomy of clotted human dialysis grafts. The physical and gross physical characteristics of all plugs were analyzed. Eight specimens were evaluated microscopically. Transcatheter compression thrombectomy of eight plugs was attempted in vitro. Each plug was embedded in a polyvinyl tube filled with newly clotted blood and connected to a flow circuit. First, balloon-assisted aspiration thrombectomy (BAT) of soft thrombus was performed, while sparing the distal-most segment containing the plug. The tulip sheath was then introduced facing the "arterial end" of the tube. The thrombus segment containing the plug was pulled back into the tulip mesh using either a 3 Fr Fogarty balloon catheter or a self-expanding rake. The tulip was closed to compress and remove the trapped plug. Near-complete thrombectomy of soft clot was achieved in all tested tubes. Compression and retrieval of the entire arterial plug was successful in all except one, where only partial compression of the plug occurred, presumably due to fibrotic changes. No fragmentation or embolization occurred in the remaining procedures. Spongy consistency was noted in 94% of the specimens. Microscopic evaluation showed organized layered thrombus with compaction in five plugs. Transcatheter removal of a thrombus plug is feasible in vitro using the tulip compression-thrombectomy system.</description><subject>Anastomosis</subject><subject>Arteriovenous Shunt, Surgical</subject><subject>Balloon catheters</subject><subject>Balloon treatment</subject><subject>Biological and medical sciences</subject><subject>BLOOD</subject><subject>Blood clots</subject><subject>Catheterization - instrumentation</subject><subject>Catheterization - methods</subject><subject>Catheters</subject><subject>Circuits</subject><subject>CLOSURES</subject><subject>Compression</subject><subject>DIALYSIS</subject><subject>Diseases of the cardiovascular system</subject><subject>Embolization</subject><subject>Feasibility</subject><subject>Graft Occlusion, Vascular - therapy</subject><subject>Grafting</subject><subject>GRAFTS</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>IN VITRO</subject><subject>Medical instruments</subject><subject>Medical sciences</subject><subject>Models, Structural</subject><subject>Physical characteristics</subject><subject>Physical properties</subject><subject>Plugs</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Renal Dialysis</subject><subject>Retrieval</subject><subject>Segments</subject><subject>Sheaths</subject><subject>SURGERY</subject><subject>THERAPY</subject><subject>Thrombectomy - instrumentation</subject><subject>Thrombectomy - methods</subject><subject>Thrombolysis</subject><subject>Thrombosis</subject><subject>Thrombosis - therapy</subject><subject>Tubes</subject><subject>Tulipa</subject><subject>VASCULAR DISEASES</subject><issn>0174-1551</issn><issn>1432-086X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpd0U1rGzEQBmARGhwn7THHgGhDb9uOpN2VlFtI8wWBluBDb0KStbbCetfVaA3591WwCbSngZmHF42GkHMG3xiA_I4AXILWAIy3R2TOasErUO3vD2QOTNYVaxp2Qk4RXwppFG9mZKZBQMNgTn79iLZ_xYh0lWyXkdqUQyo9uu2nFb2izyGnGHalMWEcVjSvA81TH7cU18HmNV2GXfSBxoHuYk7jR3Lc2R7Dp0M9I4u728XNQ_X08_7x5vqp8kLyXAUtnVPQ-c46JS1rQEhoJWvL-8B2S9nUYF0L2rtat5wL4bl1Xotl5zRz4ox82ceOmKNBH3Pwaz8OQ_DZcAYKOG-L-rpX2zT-mQJms4noQ9_bIYwTGqmU4LXQBX7-D76MUxrKAkZyqTRIBQVVe-TTiJhCZ7Ypbmx6NQzM2y3MP7co_uIQOrlNWL7rw-eX-eVhbtHbvkt28BHfWUkAVivxFzlCjrc</recordid><startdate>19970301</startdate><enddate>19970301</enddate><creator>SHARAFUDDIN, M. 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Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Renal Dialysis</topic><topic>Retrieval</topic><topic>Segments</topic><topic>Sheaths</topic><topic>SURGERY</topic><topic>THERAPY</topic><topic>Thrombectomy - instrumentation</topic><topic>Thrombectomy - methods</topic><topic>Thrombolysis</topic><topic>Thrombosis</topic><topic>Thrombosis - therapy</topic><topic>Tubes</topic><topic>Tulipa</topic><topic>VASCULAR DISEASES</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SHARAFUDDIN, M. J</creatorcontrib><creatorcontrib>TITUS, J. L</creatorcontrib><creatorcontrib>GU, X</creatorcontrib><creatorcontrib>HUNTER, D. 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J</au><au>TITUS, J. L</au><au>GU, X</au><au>HUNTER, D. W</au><au>AMPLATZ, K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dialysis grafts arterial plug : Retrieval using the tulip sheath device in vitro</atitle><jtitle>Cardiovascular and interventional radiology</jtitle><addtitle>Cardiovasc Intervent Radiol</addtitle><date>1997-03-01</date><risdate>1997</risdate><volume>20</volume><issue>2</issue><spage>154</spage><epage>158</epage><pages>154-158</pages><issn>0174-1551</issn><eissn>1432-086X</eissn><coden>CAIRDG</coden><abstract>The "arterial plug" is a resistant thrombus that frequently persists at the arterial anastomosis of clotted hemodialysis grafts following thrombolytic therapy. We studied the physical and morphological characteristics of the plug and determined the feasibility of transcatheter removal in vitro using the tulip compression thrombectomy system. Sixteen thrombus plugs were recovered during surgical thrombectomy of clotted human dialysis grafts. The physical and gross physical characteristics of all plugs were analyzed. Eight specimens were evaluated microscopically. Transcatheter compression thrombectomy of eight plugs was attempted in vitro. Each plug was embedded in a polyvinyl tube filled with newly clotted blood and connected to a flow circuit. First, balloon-assisted aspiration thrombectomy (BAT) of soft thrombus was performed, while sparing the distal-most segment containing the plug. The tulip sheath was then introduced facing the "arterial end" of the tube. The thrombus segment containing the plug was pulled back into the tulip mesh using either a 3 Fr Fogarty balloon catheter or a self-expanding rake. The tulip was closed to compress and remove the trapped plug. Near-complete thrombectomy of soft clot was achieved in all tested tubes. Compression and retrieval of the entire arterial plug was successful in all except one, where only partial compression of the plug occurred, presumably due to fibrotic changes. No fragmentation or embolization occurred in the remaining procedures. Spongy consistency was noted in 94% of the specimens. Microscopic evaluation showed organized layered thrombus with compaction in five plugs. Transcatheter removal of a thrombus plug is feasible in vitro using the tulip compression-thrombectomy system.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>9030510</pmid><doi>10.1007/s002709900126</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Cardiovascular and interventional radiology, 1997-03, Vol.20 (2), p.154-158 |
| issn | 0174-1551 1432-086X |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Anastomosis Arteriovenous Shunt, Surgical Balloon catheters Balloon treatment Biological and medical sciences BLOOD Blood clots Catheterization - instrumentation Catheterization - methods Catheters Circuits CLOSURES Compression DIALYSIS Diseases of the cardiovascular system Embolization Feasibility Graft Occlusion, Vascular - therapy Grafting GRAFTS Hemodialysis Humans IN VITRO Medical instruments Medical sciences Models, Structural Physical characteristics Physical properties Plugs RADIOLOGY AND NUCLEAR MEDICINE Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Renal Dialysis Retrieval Segments Sheaths SURGERY THERAPY Thrombectomy - instrumentation Thrombectomy - methods Thrombolysis Thrombosis Thrombosis - therapy Tubes Tulipa VASCULAR DISEASES |
| title | Dialysis grafts arterial plug : Retrieval using the tulip sheath device in vitro |
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