JAVA - Journal of the Association for Vascular Access最新文献

{"title":"Effect of exercises on the maturation of newly created arteriovenous fistulas over distal and proximal upper limb: A systematic review and meta-analysis.","authors":"Lingyan Meng, Tiying Zhang, Pei Ho","doi":"10.1177/11297298221100446","DOIUrl":"10.1177/11297298221100446","url":null,"abstract":"<p><p>The aims of our review were: (i) to evaluate the effect of post-operative upper extremity exercise on maturation of AVFs, stratified by their locations. (ii) To evaluate the effect of pre-operative arm exercise on patients' superficial vein caliber of patients. Literature search was performed on PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and China National Knowledge Infrastructure (CNKI) to identify eligible articles. The quality of the randomized controlled trials (RCTs) were assessed using the Cochrane Risk of Bias tool 2.0. In the Meta-analysis, Risk ratios (RRs) of clinical maturation and ultrasonographic maturation were pooled from studies focused on post-operative exercise program; Mean difference (MD) of venous caliver was pooled from those studied pre-operative exercise. Nine studies (six for post-operative exercise; three for pre-operative exercise) were included in the review. Among the AVFs created in distal region (158 patients in exercise group and 144 patients in control group), there was a significantly superior clinical maturation (RR: 1.28; 95% CI: 1.10-1.48, <i>p</i> = 0.001; <i>I</i>² = 0), and ultrasonographic maturation (RR: 1.30; 95% CI: 1.07-1.59, <i>p</i> = 0.009; <i>I</i>² = 0) in the exercise group in comparison to the control group. For the AVFs created in proximal region (93 and 96 patients in exercise group and control group respectively), there is no significant difference in clinical maturation (RR:1.25, 95% CI: 0.88-1.78, <i>p</i> = 0.27, <i>I</i>² = 74%) and ultrasonographic maturation (RR: 1.17, 95% CI: 0.97-1.40, <i>p</i> = 0.11, <i>I</i>² = 43%) between the exercise group and controls. For pre-operative exercise, the mean difference of 0.34 mm (95% CI: 0.23-0.46, <i>p</i> < 0.001, <i>I</i>² = 87% ) was found for vein size. In conclusion, existing upper extremity exercise programs appear to be useful in facilitating maturation of AVFs created in distal region, while its effect on fistulas created in proximal region is less certain. However, more robust trials are warranted to establish these findings.</p>","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80351332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and compliance of peripheral intravenous catheter documentation: A prospective observational study.","authors":"Amit Bahl, Nicholas Mielke, Steven Johnson","doi":"10.1177/11297298221097555","DOIUrl":"10.1177/11297298221097555","url":null,"abstract":"<p><strong>Objective: </strong>Proper documentation of the functionality and complications of peripheral intravenous catheters (PIVC) is the standard of care. This data can improve communication among team members about access concerns and highlight opportunities to improve PIVC care. Our objective is to determine if nursing personnel are compliant with institutional standards for documentation and documentation is reliable.</p><p><strong>Methods: </strong>This prospective observational analysis was conducted at a tertiary care academic center with 120,000 ED visits and 1100 hospital beds. Adults over 18 with a PIVC placed in the ED via palpation technique who were being admitted to regular medical/surgical wards were eligible. The primary outcome was compliance with PIVC documentation per institutional standards. Secondary outcomes included compliance subcategorized as insertion, daily assessment, and removal and reliability of assessments.</p><p><strong>Results: </strong>During July and August 2020, 77 patients were enrolled with a total of 1201 observations of PIVC compliance. PIVC documentation compliance was 86.0% (1033/1201). Compliance on insertion and removal was 93.3% (431/462) and 80.5% (186/231), respectively, with removal assessment being the least compliant at 49.4%. Daily catheter assessments were compliant 81.9% (416/508) of the time. PIVC documentation reliability was based on 693 total observations with 87.9% (609/693) reliability overall, and a reliability of 91.6% (423/462) and 74.9% (173/231) for insertion and removal, respectively. PIVC orientation had the highest reliability (98.7%) while post-removal assessment had the lowest reliability (45.5%).</p><p><strong>Conclusions: </strong>We observed moderate documentation compliance and reliability for PIVC assessments for catheters placed in the ED. Documentation of removal-related variables was the most deficient aspect of the assessments. Given the high rate of PIVC failure and its vast array of consequences, improvement of PIVC documentation of removal reasons is essential to better identify type and incidence of complications and help develop targeted solutions. Further larger studies are needed to survey PIVC documentation practices.</p>","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87327384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Superficial Vein Assessment (RaSuVA): A pre-procedural systematic evaluation of superficial veins to optimize venous catheterization in neonates.","authors":"Vito D'Andrea, Giorgia Prontera, Lucilla Pezza, Giovanni Barone, Giovanni Vento, Mauro Pittiruti","doi":"10.1177/11297298221098481","DOIUrl":"10.1177/11297298221098481","url":null,"abstract":"<p><strong>Background: </strong>Placement of peripheral intra-venous cannulas and epicutaneo-caval catheters is routinely performed in in Neonatal Intensive Care Unit (NICU), and both devices require visible superficial veins easy to cannulate. NICU patients are intrinsically characterized by poor and fragile vein asset, so that puncture and cannulation of superficial veins is often a challenge even for trained clinicians and cannulation frequently results in a stressful, painful, difficult procedure.</p><p><strong>Methods and results: </strong>Rapid Superficial Vein Assessment is meant to offer a systematic pre-procedural evaluation of all superficial veins of the newborn, so to allow a rational choice of the best insertion site, tailored on the single patient, and optimized for the specific type of venous access device. The superficial veins are examined systematically, both with and without NIR technology, exploring seven skin areas in the following order: (1) medial malleolus, (2) lateral malleolus, (3) retro-popliteal fossa, (4) back of the hand and wrist, (5) antecubital fossa, (6) anterior scalp surface, and (7) posterior scalp surface.</p><p><strong>Conclusions: </strong>The aim of the protocol is to increase the first attempt success rate and reduce the duration of the procedure, the number of attempts for single patient and possibly to limit complications, stress, and pain in neonates.</p>","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89625010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of clinical guideline education on the knowledge and practice of nurses for peripheral intravenous catheter placement based on short message service: A quasi-experimental study.","authors":"Hengameh Mousavi, Atefeh Ghanbari, Samad Karkhah, Javad Alizadeh, Ehsan Kazemnejad Leyli, Fateme Jafaraghaee","doi":"10.1177/11297298221101804","DOIUrl":"10.1177/11297298221101804","url":null,"abstract":"<p><strong>Background: </strong>Peripheral intravenous catheter (PIVC) placement is the most common invasive clinical procedure, often performed by nurses in hospitals worldwide. This study aimed to assess the effect of clinical guideline education on the knowledge and practice of nurses for PIVC placement based on short message service (SMS).</p><p><strong>Methods: </strong>In a quasi-experimental study with parallel groups, 66 nurses working in two general university hospitals in Iran were enrolled. Data was collected from 2017 to 2018. PIVC placement was assessed before, immediately, and 4 weeks after educational intervention based on SMS (twice a day for 10 days).</p><p><strong>Results: </strong>Nurses' knowledge score immediately after intervention versus before intervention was higher in the intervention group than in the control group (4.48 vs -0.70; <i>p</i> < 0.001). Nurses' knowledge score in 4 weeks after intervention versus immediately after intervention was lower in the intervention group than in the control group (0.03 vs 0.42; <i>p</i> = 0.014). Nurses' knowledge scores 4 weeks after intervention versus before intervention was higher in the intervention group than in the control group (4.52 vs -0.27; <i>p</i> < 0.001). Nurses' practice score immediately after intervention versus before intervention was higher in the intervention group than in the control group (0.57 vs -0.18; <i>p</i> = 0.174). Nurses' practice score 4 weeks after intervention vs immediately after intervention was higher in the intervention group than in the control group (-0.10 vs -0.38; <i>p</i> = 0.046). Nurses' practice scores 4 weeks after intervention versus before intervention was higher in the intervention group than in the control group (0.47 vs -0.56; <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>Educational intervention by SMS had a significant effect on increasing the knowledge and practice of nurses toward clinical guidelines for PIVC placement. Therefore, it is suggested that educational intervention by SMS be conducted to improve nurses' knowledge as an effective educational method.</p>","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76168972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative pressure wound therapy for prolonged surgical wound healing after brachiobasilic arteriovenous fistula creation in a patient with end-stage liver failure.","authors":"Kanako Takai, Maki Saeki, Seiji Takaoka, Yusuke Tada, Ryuta Fujimura, Tamaki Harada, Takashi Yamauchi, Hodaka Kumano","doi":"10.1177/11297298221106102","DOIUrl":"10.1177/11297298221106102","url":null,"abstract":"<p><p>A 54-year-old male patient diagnosed with hepatorenal syndrome caused by decompensated alcoholic cirrhosis was referred for arteriovenous fistula (AVF) creation after initiation of hemodialysis. A brachiobasilic arteriovenous fistula (BBAVF) was created because neither forearm had suitable vasculature. Large-volume serous effusion from the incision persisted postoperatively, and we started negative pressure wound therapy (NPWT) for wound protection. The effusion volume decreased gradually; however, up to 80 ml of discharge continued daily. Re-operation was performed 35 days after the initial operation, followed by continued NPWT. The wound was almost healed 85 days after the primary surgery. We present a case of severe surgical wound complication after AVF creation in a patient with hemostatic and coagulation disorders and malnutrition caused by end-stage hepatic failure. We confirmed the usefulness of NPWT for excessive surgical wound effusion and the adequacy of BBAVF for vascular access.</p>","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75739122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of peripherally inserted central catheters with a dedicated vascular access specialists team versus centrally inserted central catheters in the management of septic shock patients in the ICU.","authors":"Hassan A Raza, Brandon T Nokes, Bruno Alvarez, Julie Colquist, John Park, Rahul Kashyap, Bhavesh Patel, Rodrigo Cartin-Ceba","doi":"10.1177/11297298221105323","DOIUrl":"10.1177/11297298221105323","url":null,"abstract":"<p><strong>Objectives: </strong>Peripherally inserted central catheters (PICCs) are increasingly recognized as an alternative to centrally inserted central catheters (CICCs) in critical care, yet the data regarding the safety and feasibility of this choice in septic shock management is growing but still lacking. In this study, we aimed to determine the feasibility, safety, and impact on outcomes of using dedicated vascular access specialist (VAS) teams to insert PICCs versus CICCs on patients admitted to the ICU with septic shock.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Mayo Clinic Rochester Medical ICU and Mayo Clinic Arizona Multidisciplinary ICU from 2013 to 2016.</p><p><strong>Patients: </strong>All adult patients hospitalized with diagnosis of septic shock excluding patients who declined authorization for review of their medical records, mixed shock states, and readmissions.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurement and main results: </strong>Comprehensive data regarding septic shock diagnosis and resuscitation were abstracted from electronic medical records. A total of 562 patients with septic shock were included in the study; 215 patients were resuscitated utilizing a PICC and 347 were resuscitated using a CICC. On univariate analysis, the time to central line insertion and time to vasopressor initiation were found to be reduced in those who received PICC at time of ICU admission versus CICC. Other favorable outcomes were also observed in those who received PICC versus CICC including shorter ICU length of stay and lower unadjusted hospital mortality. A multivariable analysis for hospital mortality showed that after adjusting for important covariates, neither the time to central line insertion nor the time to vasopressor initiation was associated with a lower hospital mortality.</p><p><strong>Conclusions: </strong>Across two tertiary referral centers within the same enterprise, use of a dedicated VAS team for insertion of PICCs for initial resuscitation in patients with septic shock was feasible and associated with shorter time to central venous access and initiation of vasopressors; however, adjusted hospital mortality was not different between the two groups.</p>","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75794299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A national co-design workshop of a mobile-based application for vascular access as a patient decision aid.","authors":"David Kingsmore, Ramsay Meiklem, Karen Stevenson, Peter Thomson, Matt Bouamrane, Mark Dunlop","doi":"10.1177/11297298221091140","DOIUrl":"10.1177/11297298221091140","url":null,"abstract":"<p><strong>Background: </strong>Increasing options for vascular access have increased the need for more effective communication to optimize patient engagement and ensure effective consent. An advanced prototype of the mobile application (VA App) was developed over 3 years as a patient decision aid. For the first time, entry to the 2021 UK Kidney Week was opened to all professions and patients and was held online. The VA App was presented in an inter-active session. This report summarizes the findings.</p><p><strong>Methods: </strong>A 30-min interactive session was allocated with the session delivered in four sections: (1) demographic data was collected; (2) an overall opinion was obtained about current patient information sources and satisfaction with these; (3) the participants were asked a series of eight questions regarding the main problem areas previously identified; (4) following a 6-min demonstration video, the participants were then re-asked the same questions to determine if the VA App would improve/worsen these areas.</p><p><strong>Results: </strong>Completed data from 30 participants showed great variation in all demographics. The most cited source was verbal and rated the best, whilst all other sources were felt to be poor by 90%. All eight aspects of current information sources rated poorly. There was a unanimous agreement that the VA App could make this better. Interestingly, when the eight aspects were ranked by order of the worst to best, this matched the order of the benefits of the VA App.</p><p><strong>Discussion: </strong>This is the first report of an on-line, multi-professional co-design workshop. With a unanimous view that current systems are very limited and that better patient information systems are required, the VA App was found to be a potential solution as a patient decision aid. Interestingly, paper leaflets were widely viewed as the least used and the least effective mechanism for communicating information to patients. Funding for a commercially produced mobile application has been secured and will be further tested in the near future.</p>","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81166658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective clinical study on the incidence of catheter-related complications in a neurological intensive care unit: 4 years of experience.","authors":"Denise Bolis, Sonia D'Arrigo, Alessandro Bartesaghi, Cristina Panzeri, Paola Pelegalli, Alberto Steffanoni, Giancarlo Scoppettuolo, Mauro Pittiruti","doi":"10.1177/11297298221097267","DOIUrl":"10.1177/11297298221097267","url":null,"abstract":"<p><strong>Introduction: </strong>Over the past decades, significant efforts have been made to reduce early and late catheter-related complications in critically ill patients, using approaches based on bundles of evidence-based interventions.</p><p><strong>Methods: </strong>In this prospective clinical study, the authors evaluated the incidence of catheter-related complications in their neuro-intensive care unit during a 4-year period, adopting systematically the GAVeCeLT bundles for the insertion and management of all central venous access devices: centrally inserted central catheters (CICCs), peripherally inserted central catheters (PICCs) and femorally inserted central catheters (FICCs). All early/immediate and late complications were recorded.</p><p><strong>Results: </strong>On 486 central lines (328 CICCs, 149 PICCs and 9 FICCs), the only clinically relevant early/immediate complication was primary tip malposition (1%). In regards late infective complications, the authors did not record any case of catheter-related bloodstream infection; though, they observed one case of central line associated blood stream infection (one CICC; 0.14/1000 catheter days), and 15 cases of catheter colonization (12 CICCs and 3 PICCs; 2.09 episodes/1000 catheter days). Late non-infective complications were few: 14 accidental dislodgments (2.9%), 18 irreversible lumen occlusions (3.7%), and no episodes of symptomatic catheter-related thrombosis or tip migration.</p><p><strong>Conclusion: </strong>The systematic adoption of the GAVeCeLT bundles for CVAD insertion and maintenance was associated with a minimization of catheter-related complications. The strict adherence to the recommendations included in these bundles was the major determinant for clinical success.</p>","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76082645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized controlled study to compare first stick success with Instaflash technology: The FIRSST study.","authors":"Arun Mavaji Seetharam, Umashankar Raju, K Suresh","doi":"10.1177/11297298221080369","DOIUrl":"10.1177/11297298221080369","url":null,"abstract":"<p><strong>Background: </strong>Peripheral intravenous catheters (PIVCs) are frequently used in clinical settings for intravenous access. Multiple attempts of PIVC insertions leads to patient discomfort, delay in treatment, associated complications, and extensive expenditure cost. Reduced number of attempts causes patient/nursing personnel satisfaction and expenditure costs. The present study evaluated performance efficacy of BD Venflon™ I with Instaflash needle technology (investigational device) as compared to the BD Venflon™ without Instaflash needle technology (control device).</p><p><strong>Methodology: </strong>The PIVC insertions were randomized in the ratio 1:1 using either investigational or control device and were monitored for first stick success rate, ease of insertion, and patient satisfaction. Data was analyzed using R 4.0.3 and Microsoft Excel. Chi square test was used to establish association between two categorical variables.</p><p><strong>Results: </strong>In total, 1402 patients were analyzed for first attempt insertion success which showed 98.72% success rate in investigational device as compared to 88.87% success rate in case of the control device (<i>p</i> = 0.0004). Marginal differences were observed in ease of insertion in investigational (98.71%) and control devices (99%) signifying high satisfaction levels of nursing personnels. Positive responses were observed in investigational (98.01%) and control devices (99%) underlining satisfactory performances of overall patient experiences.</p><p><strong>Conclusion: </strong>The present study showed that BD Venflon™ I with Instaflash needle technology enhanced first attempt insertion success rate along with marginal differences in its efficacy in comparison with the BD Venflon™ without Instaflash needle technology thus enhancing patient and nursing personnel satisfaction in turn making it a better alternative to be used in hospitals.</p>","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76042282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of vacuum-assisted mechanical thrombectomy in the management of acutely thrombosed arteriovenous fistulas and grafts.","authors":"Rafael Noronha Cavalcante, Kenji Nishinari, Guiherme Centofanti, Mariana Krutman, Bruna De Fina, Victor Hamamoto Sato, Erico Souza de Oliveira, Leonardo Victor Barbosa Pereira, Sara Mohrbacher, Alessandra Martins Bales, Bernadete Maria Coelho Ferreira, Precil Diego Miranda de Menezes Neves, Pedro Renato Chocair, Américo Lourenço Cuvello Neto","doi":"10.1177/11297298221099469","DOIUrl":"10.1177/11297298221099469","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to evaluate the safety and efficacy of the mechanical thrombectomy with the Indigo System in the treatment of thrombosed arteriovenous fistulas and grafts.</p><p><strong>Methods: </strong>A retrospective search of endovascular procedures performed from November 2018 to June 2020 was conducted. Inclusion criteria were: acute arteriovenous fistula or graft thrombosis that underwent endovascular mechanical thrombectomy with Indigo System. The following information was collected from each case: sex, age, fistula modality, fistula location, treatment modality, and outcomes. Endpoints evaluated were: technical and clinical success rates; primary, assisted primary, and secondary patency rates; complication rates.</p><p><strong>Results: </strong>Twenty-six mechanical thrombectomy procedures for declotting of arteriovenous fistula thrombosis, using the Indigo System, were performed in 22 patients. Technical and clinical success was achieved in 23/26 cases (88%). Mean follow-up was 9 months (range 11-539 days). The 6-month primary, primary assisted, and secondary patency rates were 71%, 86%, 93% and the 12-month primary, primary assisted, and secondary patency rates were 71%, 72%, 80%, respectively. No technical or device-related complications were observed during thrombectomy, however two venous ruptures occurred on the angioplasty of the underlying stenosis.</p><p><strong>Conclusion: </strong>In conclusion, vacuum-assisted thrombectomy of acutely thrombosed arteriovenous fistulas and grafts with Indigo System is safe and effective, providing good short term patency rates.</p>","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88984744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}