A New Mechanical Device for Declotting of Hemodialysis Access Grafts: First Clinical Experience
Purpose: To review the early clinical experience with a new mechanical thrombectomy device for declotting polytetrafluoroethylene (PTFE) hemodialysis access (HDA) grafts. Methods: The XTD is a 6-F introducer-compatible device that pulverizes clot with a rotating curved tip driven by a flexible spira...
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| Veröffentlicht in: | Journal of endovascular therapy 2005-04, Vol.12 (2), p.215-223 |
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| creator | Yoffe, Boris Behar, Daniel J. Scheinowitz, Mickey Rabin, Andrew M. |
| description | Purpose:
To review the early clinical experience with a new mechanical thrombectomy device for declotting polytetrafluoroethylene (PTFE) hemodialysis access (HDA) grafts.
Methods:
The XTD is a 6-F introducer-compatible device that pulverizes clot with a rotating curved tip driven by a flexible spiral shaft. Fragments are aspirated into a collection container. Fifty patients (32 women; mean age 66 years) with clotted 6-mm polytetrafluoroethylene HDA grafts were treated at 2 medical centers in a study spanning 22 months. In all, 59 procedures were performed on an outpatient basis under monitored conscious sedation. Ancillary techniques were used as needed to treat the underlying cause of the clot. Technical success was defined on a per-procedure basis as removal of sufficient thrombus to visualize the underlying disease without major device-related complications.
Results:
Technical success was 100%; no device-related adverse events occurred. Immediate clinical success was achieved in 47/59 (80%) cases. Continued clinical success in survivors was 52% (30/58) at 1 month and 46% (26/56) at 3 months. Eliminating from analysis a high-risk patient subgroup (reocclusions, chronically clotted or unsalvageable grafts, untreatable central venous stenosis, and venous anastomoses resistant to wire/catheter passage) increased the 3-month clinical success to 59% (22/37).
Conclusions:
The XTD is a promising device capable of safely and effectively declotting PTFE grafts. Further investigation is warranted. |
| doi_str_mv | 10.1583/04-1270R.1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67729677</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1583_04-1270R.1</sage_id><sourcerecordid>855603081</sourcerecordid><originalsourceid>FETCH-LOGICAL-c259t-bb550b6bc806fce8c9e006e8f94e5d3f252b6fe3185bc066a5340c62d62c07773</originalsourceid><addsrcrecordid>eNptkE1LAzEQhoMoflQv_gAJHhSE1Ul2k931VupHhaogeg7Z7EQj-1GTrdp_79YWCuJp3sMzzwwvIYcMzpnI4gtIIsZTeDpnG2SXiURETAjYXGQuIwk82yF7IbwDcMYZ2yY7_RqPQea7RA3pA37RezRvunFGV_QKP51BalvfR1O1XeeaV9paOsa6LZ2u5sEFOjQGQ6C3XtsuXNIb50NHR5VbOq6_p-gdNgb3yZbVVcCD1RyQl5vr59E4mjze3o2Gk8hwkXdRUfQfF7IwGUhrMDM5AkjMbJ6gKGPLBS-kxZhlojAgpRZxAkbyUnIDaZrGA3Ky9E59-zHD0KnaBYNVpRtsZ0HJNOW5_AWP_4Dv7cw3_W-q7wYyyGPWQ2dLyPg2BI9WTb2rtZ8rBmrRuYJE_XauFvDRyjgraizX6KrkHjhdAkG_4vrcP6off_-Gig</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211080931</pqid></control><display><type>article</type><title>A New Mechanical Device for Declotting of Hemodialysis Access Grafts: First Clinical Experience</title><source>MEDLINE</source><source>SAGE Complete A-Z List</source><creator>Yoffe, Boris ; Behar, Daniel J. ; Scheinowitz, Mickey ; Rabin, Andrew M.</creator><creatorcontrib>Yoffe, Boris ; Behar, Daniel J. ; Scheinowitz, Mickey ; Rabin, Andrew M.</creatorcontrib><description>Purpose:
To review the early clinical experience with a new mechanical thrombectomy device for declotting polytetrafluoroethylene (PTFE) hemodialysis access (HDA) grafts.
Methods:
The XTD is a 6-F introducer-compatible device that pulverizes clot with a rotating curved tip driven by a flexible spiral shaft. Fragments are aspirated into a collection container. Fifty patients (32 women; mean age 66 years) with clotted 6-mm polytetrafluoroethylene HDA grafts were treated at 2 medical centers in a study spanning 22 months. In all, 59 procedures were performed on an outpatient basis under monitored conscious sedation. Ancillary techniques were used as needed to treat the underlying cause of the clot. Technical success was defined on a per-procedure basis as removal of sufficient thrombus to visualize the underlying disease without major device-related complications.
Results:
Technical success was 100%; no device-related adverse events occurred. Immediate clinical success was achieved in 47/59 (80%) cases. Continued clinical success in survivors was 52% (30/58) at 1 month and 46% (26/56) at 3 months. Eliminating from analysis a high-risk patient subgroup (reocclusions, chronically clotted or unsalvageable grafts, untreatable central venous stenosis, and venous anastomoses resistant to wire/catheter passage) increased the 3-month clinical success to 59% (22/37).
Conclusions:
The XTD is a promising device capable of safely and effectively declotting PTFE grafts. Further investigation is warranted.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1583/04-1270R.1</identifier><identifier>PMID: 15823069</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Aged ; Angioplasty - instrumentation ; Arteriovenous Shunt, Surgical - adverse effects ; Catheters, Indwelling - adverse effects ; Equipment Design ; Female ; Follow-Up Studies ; Graft Occlusion, Vascular - diagnostic imaging ; Graft Occlusion, Vascular - etiology ; Graft Occlusion, Vascular - surgery ; Humans ; Male ; Middle Aged ; Radiography ; Renal Dialysis ; Thrombectomy - instrumentation ; Treatment Outcome</subject><ispartof>Journal of endovascular therapy, 2005-04, Vol.12 (2), p.215-223</ispartof><rights>2005 SAGE Publications</rights><rights>Copyright Allen Press, Inc. Apr 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c259t-bb550b6bc806fce8c9e006e8f94e5d3f252b6fe3185bc066a5340c62d62c07773</citedby><cites>FETCH-LOGICAL-c259t-bb550b6bc806fce8c9e006e8f94e5d3f252b6fe3185bc066a5340c62d62c07773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1583/04-1270R.1$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1583/04-1270R.1$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21817,27922,27923,43619,43620</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15823069$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yoffe, Boris</creatorcontrib><creatorcontrib>Behar, Daniel J.</creatorcontrib><creatorcontrib>Scheinowitz, Mickey</creatorcontrib><creatorcontrib>Rabin, Andrew M.</creatorcontrib><title>A New Mechanical Device for Declotting of Hemodialysis Access Grafts: First Clinical Experience</title><title>Journal of endovascular therapy</title><addtitle>J Endovasc Ther</addtitle><description>Purpose:
To review the early clinical experience with a new mechanical thrombectomy device for declotting polytetrafluoroethylene (PTFE) hemodialysis access (HDA) grafts.
Methods:
The XTD is a 6-F introducer-compatible device that pulverizes clot with a rotating curved tip driven by a flexible spiral shaft. Fragments are aspirated into a collection container. Fifty patients (32 women; mean age 66 years) with clotted 6-mm polytetrafluoroethylene HDA grafts were treated at 2 medical centers in a study spanning 22 months. In all, 59 procedures were performed on an outpatient basis under monitored conscious sedation. Ancillary techniques were used as needed to treat the underlying cause of the clot. Technical success was defined on a per-procedure basis as removal of sufficient thrombus to visualize the underlying disease without major device-related complications.
Results:
Technical success was 100%; no device-related adverse events occurred. Immediate clinical success was achieved in 47/59 (80%) cases. Continued clinical success in survivors was 52% (30/58) at 1 month and 46% (26/56) at 3 months. Eliminating from analysis a high-risk patient subgroup (reocclusions, chronically clotted or unsalvageable grafts, untreatable central venous stenosis, and venous anastomoses resistant to wire/catheter passage) increased the 3-month clinical success to 59% (22/37).
Conclusions:
The XTD is a promising device capable of safely and effectively declotting PTFE grafts. Further investigation is warranted.</description><subject>Aged</subject><subject>Angioplasty - instrumentation</subject><subject>Arteriovenous Shunt, Surgical - adverse effects</subject><subject>Catheters, Indwelling - adverse effects</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft Occlusion, Vascular - diagnostic imaging</subject><subject>Graft Occlusion, Vascular - etiology</subject><subject>Graft Occlusion, Vascular - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Radiography</subject><subject>Renal Dialysis</subject><subject>Thrombectomy - instrumentation</subject><subject>Treatment Outcome</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNptkE1LAzEQhoMoflQv_gAJHhSE1Ul2k931VupHhaogeg7Z7EQj-1GTrdp_79YWCuJp3sMzzwwvIYcMzpnI4gtIIsZTeDpnG2SXiURETAjYXGQuIwk82yF7IbwDcMYZ2yY7_RqPQea7RA3pA37RezRvunFGV_QKP51BalvfR1O1XeeaV9paOsa6LZ2u5sEFOjQGQ6C3XtsuXNIb50NHR5VbOq6_p-gdNgb3yZbVVcCD1RyQl5vr59E4mjze3o2Gk8hwkXdRUfQfF7IwGUhrMDM5AkjMbJ6gKGPLBS-kxZhlojAgpRZxAkbyUnIDaZrGA3Ky9E59-zHD0KnaBYNVpRtsZ0HJNOW5_AWP_4Dv7cw3_W-q7wYyyGPWQ2dLyPg2BI9WTb2rtZ8rBmrRuYJE_XauFvDRyjgraizX6KrkHjhdAkG_4vrcP6off_-Gig</recordid><startdate>200504</startdate><enddate>200504</enddate><creator>Yoffe, Boris</creator><creator>Behar, Daniel J.</creator><creator>Scheinowitz, Mickey</creator><creator>Rabin, Andrew M.</creator><general>SAGE Publications</general><general>Allen Press Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>200504</creationdate><title>A New Mechanical Device for Declotting of Hemodialysis Access Grafts: First Clinical Experience</title><author>Yoffe, Boris ; Behar, Daniel J. ; Scheinowitz, Mickey ; Rabin, Andrew M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c259t-bb550b6bc806fce8c9e006e8f94e5d3f252b6fe3185bc066a5340c62d62c07773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Angioplasty - instrumentation</topic><topic>Arteriovenous Shunt, Surgical - adverse effects</topic><topic>Catheters, Indwelling - adverse effects</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Graft Occlusion, Vascular - diagnostic imaging</topic><topic>Graft Occlusion, Vascular - etiology</topic><topic>Graft Occlusion, Vascular - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Radiography</topic><topic>Renal Dialysis</topic><topic>Thrombectomy - instrumentation</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoffe, Boris</creatorcontrib><creatorcontrib>Behar, Daniel J.</creatorcontrib><creatorcontrib>Scheinowitz, Mickey</creatorcontrib><creatorcontrib>Rabin, Andrew M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endovascular therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoffe, Boris</au><au>Behar, Daniel J.</au><au>Scheinowitz, Mickey</au><au>Rabin, Andrew M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A New Mechanical Device for Declotting of Hemodialysis Access Grafts: First Clinical Experience</atitle><jtitle>Journal of endovascular therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2005-04</date><risdate>2005</risdate><volume>12</volume><issue>2</issue><spage>215</spage><epage>223</epage><pages>215-223</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>Purpose:
To review the early clinical experience with a new mechanical thrombectomy device for declotting polytetrafluoroethylene (PTFE) hemodialysis access (HDA) grafts.
Methods:
The XTD is a 6-F introducer-compatible device that pulverizes clot with a rotating curved tip driven by a flexible spiral shaft. Fragments are aspirated into a collection container. Fifty patients (32 women; mean age 66 years) with clotted 6-mm polytetrafluoroethylene HDA grafts were treated at 2 medical centers in a study spanning 22 months. In all, 59 procedures were performed on an outpatient basis under monitored conscious sedation. Ancillary techniques were used as needed to treat the underlying cause of the clot. Technical success was defined on a per-procedure basis as removal of sufficient thrombus to visualize the underlying disease without major device-related complications.
Results:
Technical success was 100%; no device-related adverse events occurred. Immediate clinical success was achieved in 47/59 (80%) cases. Continued clinical success in survivors was 52% (30/58) at 1 month and 46% (26/56) at 3 months. Eliminating from analysis a high-risk patient subgroup (reocclusions, chronically clotted or unsalvageable grafts, untreatable central venous stenosis, and venous anastomoses resistant to wire/catheter passage) increased the 3-month clinical success to 59% (22/37).
Conclusions:
The XTD is a promising device capable of safely and effectively declotting PTFE grafts. Further investigation is warranted.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>15823069</pmid><doi>10.1583/04-1270R.1</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Journal of endovascular therapy, 2005-04, Vol.12 (2), p.215-223 |
| issn | 1526-6028 1545-1550 |
| language | eng |
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| source | MEDLINE; SAGE Complete A-Z List |
| subjects | Aged Angioplasty - instrumentation Arteriovenous Shunt, Surgical - adverse effects Catheters, Indwelling - adverse effects Equipment Design Female Follow-Up Studies Graft Occlusion, Vascular - diagnostic imaging Graft Occlusion, Vascular - etiology Graft Occlusion, Vascular - surgery Humans Male Middle Aged Radiography Renal Dialysis Thrombectomy - instrumentation Treatment Outcome |
| title | A New Mechanical Device for Declotting of Hemodialysis Access Grafts: First Clinical Experience |
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