Rotational Devices Superior To Hydrolyser In Thrombosed Haemodialysis Grafts

Rotational devices remove clots from thrombosed haemodialysis grafts more effectively than the Hydrolyser. However, only percutaneous transluminal angioplasty's efficacy predicted patency.

Currently, thrombosed haemodialysis grafts are treated using percutaneous thrombolysis, although available devices use several mechanisms to macerate the clot, including aspiration and fragmentation. Researchers from University Medical Centre, Utrecht, The Netherlands, removed the clot using one of three devices before performing percutaneous transluminal angioplasty in 68 thrombosed haemodialysis grafts.

Thirteen grafts were treated using the Cragg brush catheter combined with urokinase. Eighteen grafts were managed using the Hydrolyser and 37 grafts using the Arrow-Trerotola Percutaneous Thrombolytic Device (PTD).

Ninety-two percent of grafts managed with the Cragg brush showed good Clot Removal Scores (CRS). The initial technical and clinical success rates using the Cragg brush were 85 and 62 percent respectively. The mean patency rates after 30, 60 and 90 days were 73, 61 and 49 percent respectively.

Using the hydrolyser, 44 percent of patients showed good CRS. The initial technical and clinical success rates with the hydrolyser were 83 and 67 percent respectively. The mean patency rates at 30, 60 and 90 days were 60, 53 and 40 percent respectively.

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