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KMID : 0364020090420040487
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Korean Journal of Thoracic and Cardiovascular Surgery
2009 Volume.42 No. 4 p.487 ~ p.491
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Comparative Analysis of Surgical Thrombectomy with Revision and Percutaneous Thrombectomy with Angioplasty for Treating Obstruction of a Dialysis Graft
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Lim Jae-Woong
Shin Hwa-Kyun
Won Young-Sun
Kim Dong-Hyun
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Abstract
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Background :Salvaging prosthetic arteriovenous grafts can be performed using surgical or endovascular techniques. We conducted a retrospective analysis to compare the efficacy of these two methods for restoring dialysis graft function.
Materials and Methods :We studied 41 patients who had received surgical thrombectomy with revision (Group A) or percutaneous thrombectomy with angioplasty (Group B) from January 2006 to December 2007. We compared them according to the patient characteristics and the location of stenotic lesions, and we analyzed the postintervention primary patency rates.
Results :21 patients underwent surgery and 20 patients underwent percutaneous balloon angioplasty. There were no significant differences of the patients’ characteristics between the two groups. Venous anastomotic stenosis was the most common cause of graft thrombosis in both groups. In Group A, 90.5% of the grafts remained functional at 6 months and 38.1% remained functional at 12 months. In Group B, 55.0% of the grafts were functional at 6 months and 20.0% of the grafts were functional at 12 months. The post-intervention primary patency rate was significantly better in Group A (p=0.034).
Conclusion :Surgical treatment resulted in significantly longer post-intervention primary patency in this study, and this supports its use as the primary method of management for most patients in whom dialysis graft obstruction develops. (Korean J Thorac Cardiovasc Surg 2009;42:487-491)
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KEYWORD
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Arteriovenous fistula, Intervention, Graft occlusion, vascular
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