Mechanical Thrombolysis of Thrombosed Hemodialysis Native Fistulas with Use of the Arrow-Trerotola Percutaneous Thrombolytic Device: Our Preliminary Experience

PURPOSE To evaluate the feasibility of use of the Arrow-Trerotola percutaneous thrombolytic device (PTD) in the treatment of thrombosed hemodialysis native fistula occlusions. MATERIALS AND METHODS Ten patients with native fistula occlusion underwent mechanical thrombolysis with use of the PTD. The standard PTD was used in seven patients and the over-the-wire device was used in three patients. Major outcomes of our study included procedure time, clinical success, complication rate, and 3-and 6-month patency rates. RESULTS The technical success rate was 100% and the clinical success rate was 90% (9 of 10). In all 10 cases, the procedure was associated with angioplasty. There were no major complications. The mean time of successful procedures was 126.1 minutes. The 3-and 6-month primary patency rates were 70% and 60%, respectively; the assisted primary patency rate at 6 months was 80%. CONCLUSION The PTD is an effective mechanical device for percutaneous treatment of thrombosed hemodialysis access. Our clinically successful initial experience with the PTD shows that the technique is rapid and safe for treatment of native fistula occlusions.