Outcomes of Percutaneous Aspiration Thrombectomy in Acute Thrombosis of Arteriovenous Access.

Objective: The objective of this study was to determine outcomes after percutaneous aspiration thrombectomy of acutely thrombosed arteriovenous dialysis access.

Methods: A retrospective review of 78 patients undergoing a total of 146 percutaneous aspiration thrombectomies of arteriovenous dialysis access between 2016 to 2020 were reviewed to evaluate outcomes. The CAT-D Suction Thrombectomy Device (Penumbra; Alameda, CA) was the device used to restore arteriovenous access patency in this study. Outcomes measured include rates of successful thrombectomy, primary patency rates, and cumulative patency rates were determined via chart review. Secondary analysis was conducted to determine factors that may affect post procedure patency.

Results: Seventy-eight patients undergoing a total of 146 percutaneous aspiration thrombectomies were studied. There was a technical success rate of 98.6% with 95.9% subsequently undergoing dialysis successfully. There were no procedural related deaths or clinically apparent pulmonary embolism. Primary patency at 30, 90, and 180 days was 58.2%, 35.6%, and 23.3% with an average primary patency of 104.5 days. Cumulative patency rates at 30, 90, and 180 days were 80.8%, 64.4%, and 54.8% with an average cumulative patency rate of 232.5 days.

Conclusions: The use of percutaneous aspiration thrombectomy in acutely thrombosed arteriovenous access is associated with high technical and clinical success rates while maintaining a low risk of complications. This study demonstrated a primary and cumulative patency rate that was lower than prior literature, but this may have been secondary to our study population consisting of greater numbers of patients with known risk factors for early access thrombosis.