Efficacy of ProLumen in Percutaneous Thrombectomy of Clotted Dialysis Access: A Single-Center Prospective Study

Abstract

Purpose To prospectively evaluate the efficacy of the ProLumen thrombectomy device for declot of dialysis access. Methods 16 women and 4 men suffering from end-stage renal disease (ESRD) dependent on hemodialysis (mean age, 66.4 years) and presenting with thrombosed dialysis access were enrolled form October 2005 through February 2006. Sixteen patients had synthetic grafts and 4 had native fistulas. Mean age of access was 24.65 months (range, 2 to 96 months). A history of previous intervention was noted for seven patients (6 percutaneous, 1 surgical). Results A mean of 2.7 passes of the ProLumen device were required for the venous limb (range, 1 to 6) and 2.35 passes for the arterial limb (range, 0 to 5). Average procedure time was 48 minutes (range 32–81 minutes). Adjunctive thrombectomy devices were utilized in 5 cases. Good angiographic and clinical results were reported in 19 patients; one patient had a poor result. Dialysis flow rate prior to thrombosis was 425 mL/min (range, 300 to 550). The mean post-thrombectomy flow rate was 380 mL/min (range, 200 to 480; n=19). “Ease of use” of Pro Lumen thrombectomy device was rated good in 17 patients. Maneuverability was good in 14 patients and clot removal around the opposite sheath was rated as good in 18 patients. Conclusions ProLumen is effective in thrombectomy of dialysis access. The device is easy to use, and effectively removes clot around the opposite sheath.