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Development of a novel catheter preventing the outflow of debris and thrombus on percutaneous transluminal angioplasty for hemodialysis access fistulas.

Authors
  • Horita, Yuki
  • Namura, Masanobu
  • Matsumura, Masami
Type
Published Article
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
Publication Date
Jun 01, 2006
Volume
67
Issue
6
Pages
961–966
Identifiers
PMID: 16649239
Source
Medline
License
Unknown

Abstract

If a large amount of debris or thrombus dislodges from a lesion because of dilation of the stenotic or occluded lesion in the hemodialysis access fistula when angioplasty is performed, it may move into the pulmonary artery via the central vein, resulting in pulmonary embolism. A novel sheath has been developed to prevent the outflow of debris or thrombus to the central vein. The catheter consists of a 5 F sheath introducer and a silicone balloon attached at the tip of the sheath. The silicon balloon is inflated via small inflation lumen on the shaft wall of the sheath. In the case of percutaneous transluminal angioplasty (PTA), the silicone balloon is inflated to block the blood flow by a mixture of contrast medium and physiological saline, and then dilate a stenotic or occluded lesion by PTA balloon. Next, the debris and thrombus are aspirated using the flush-lumen of this device. Finally, the silicone balloon is deflated and the dilation of the lesion is confirmed. A case of hemodialysis access fistula graft with massive thrombotic occlusion was presented. This device enabled Fogarty procedure using PTA balloon and the blood flow of the graft was completely improved and a large amount of thrombus was removed. This novel device is useful to prevent the embolic complication of the intervention for hemodialysis access fistula.

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