The Optimal Time of Percutaneous Pharmacomechanical Thrombolysis for the Treatment of Thrombosed Hemodialysis Arteriovenous Graft.

IF 1.4 4区医学 Q3 UROLOGY & NEPHROLOGY

Seminars in Dialysis Pub Date : 2025-03-01 Epub Date: 2025-03-03 DOI:10.1111/sdi.13251

Keerati Hongsakul, Surasee Srihasarn, Phurich Janjindamai, Surasit Akkakrisee, Kittipitch Bannangkoon, Sorracha Rookkapan, Ussanee Boonsrirat

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引用次数: 0

Abstract

Background: The optimal time for the salvaging of thrombosed hemodialysis grafts is controversial. This study was aimed at determining the optimal time related to the outcome of percutaneous pharmacomechanical thrombolysis (PMT) for the treatment of thrombosed arteriovenous graft (AVG).

Methods: This was a retrospective study of 191 hemodialysis patients who underwent PMT for thrombosed AVG from April 2014 to December 2021. Demographic data and details of the procedure were recorded. The procedural success rate related to the onset time of PMT was analyzed. The postinterventional circuit primary assisted patency rate was presented by the Kaplan-Meier curve.

Results: A total of 191 hemodialysis patients, 101 females and 90 males, were enrolled. Their median age was 66 years (interquartile range of 58-75 years). The majority type of thrombosed AVG was brachiocephalic loop graft (60.2%). The procedural success rate of PMT that was performed ≤ 48 h was 86.2%. There was a statistically significant procedural success rate of PMT in the group with an onset of treatment ≤ 48 h compared to > 48 h (odds ratio = 2.77; 95% confidence interval = 1.06, 7.28; p = 0.037). The median postintervention circuit primary assisted patency in the group of treatment ≤ 48 and > 48 h was 7.3 and 3.9 months (p = 0.023), respectively.

Conclusion: From this study, the optimal time of PMT for treatment of thrombosed AVG should be within 48 h after onset of thrombosis for enhancing procedural success and patency rates.

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经皮药物力学溶栓治疗血栓性血液透析动静脉移植物的最佳时机。

背景：血栓性血液透析移植的最佳抢救时间存在争议。本研究旨在确定与经皮药物力学溶栓（PMT）治疗血栓动静脉移植物（AVG）疗效相关的最佳时间。方法：对2014年4月至2021年12月期间因血栓性AVG接受PMT治疗的191例血液透析患者进行回顾性研究。记录了人口统计数据和手术细节。分析手术成功率与PMT发病时间的关系。Kaplan-Meier曲线表示介入后回路初级辅助通畅率。结果：共纳入191例血液透析患者，其中女性101例，男性90例。他们的中位年龄为66岁（四分位数范围为58-75岁）。血栓性AVG以头臂环移植为主（60.2%）。≤48 h的PMT手术成功率为86.2%。治疗开始≤48 h组与治疗开始≤48 h组相比，PMT的手术成功率有统计学意义(优势比= 2.77；95%置信区间= 1.06,7.28；p = 0.037)。治疗≤48 h组和治疗≤48 h组干预后回路初级辅助通畅的中位时间分别为7.3个月和3.9个月（p = 0.023）。结论：从本研究来看，PMT治疗血栓性AVG的最佳时间应在血栓形成后48 h内，以提高手术成功率和通畅率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in Dialysis 医学-泌尿学与肾脏学

CiteScore

3.00

自引率

6.20%

发文量

审稿时长

4-8 weeks

期刊介绍： Seminars in Dialysis is a bimonthly publication focusing exclusively on cutting-edge clinical aspects of dialysis therapy. Besides publishing papers by the most respected names in the field of dialysis, the Journal has unique useful features, all designed to keep you current: -Fellows Forum -Dialysis rounds -Editorials -Opinions -Briefly noted -Summary and Comment -Guest Edited Issues -Special Articles Virtually everything you read in Seminars in Dialysis is written or solicited by the editors after choosing the most effective of nine different editorial styles and formats. They know that facts, speculations, ''how-to-do-it'' information, opinions, and news reports all play important roles in your education and the patient care you provide. Alternate issues of the journal are guest edited and focus on a single clinical topic in dialysis.