Secondary Patency of Thrombosed Prosthetic Vascular Access Grafts with Aggressive Surveillance, Monitoring and Endovascular Management

This figure shows the device unit of the AngioJet Ultra Thrombectomy System, which generates the high pressure necessary to achieve isovolumetric balance between fluid delivery and removal (courtesy of Possis Medical, Inc, Minneapolis, MN, USA).

A radiograph of a thrombosed upper arm prosthetic graft that underwent percutaneous mechanical thrombectomy with the AngioJet device. Subsequent angiogram revealed the presence of significant stenosis of the venous anastomosis (arrow) and the body of the graft (arrowhead).

(a,b) The presence and severity of the lesions shown in Fig. 2 was confirmed during percutaneous balloon angioplasty, as shown by the balloon waist (3a: venous anastomosis, 3b: graft body) before they were fully dilated.

Results of balloon angioplasty of the lesions shown in . The lesion at the venous anastomosis had a residual stenosis and underwent repeat angioplasty with further improvement, as shown in the right side of the image.

Kaplan-Meier curves of postintervention functional primary, assisted primary and secondary patency of all thrombosed grafts. Error bars on the survival curves represent the standard error; the number of patients at risk at each interval is shown below the graph.

Kaplan-Meier curves of postintervention secondary patency of all thrombosed grafts in relation to time since graft placement; intermediate graft thrombosis (occurred between 31–182 days after graft placement) was associated with worse secondary patency. Error bars on the survival curves represent the standard error; the number of patients at risk at each interval is shown below the graph.

Kaplan-Meier curves of postintervention secondary patency of all thrombosed grafts in relation to the need for re-intervention (angioplasty for graft dysfunction) during follow-up. Error bars on the survival curves represent the standard error; the number of patients at risk at each interval is shown below the graph.

Kaplan-Meier curves of postintervention secondary patency of all thrombosed grafts in subgroups defined by time since graft placement and the need for re-intervention (IN: intermediate, NI: non-intermediate). Subgroup comparisons were all statistically significant with the exception of the IN-reintervention and NI-no reintervention groups comparison. Error bars on the survival curves represent the standard error; the number of patients at risk at each interval is shown below the graph.