title: Outcomes of AngioJet® thrombectomy in hemodialysis vascular access grafts and fistulas: PEARL I Registry.
abstract: OBJECTIVE
  Results are reported from the PEARL I Registry for procedures where a mid-length AngioJet catheter was used for thrombosed hemodialysis arteriovenous grafts and fistulae.
  
  
  METHODS
  The PEARL I Registry was a prospective, multicenter, observational database collecting information on the AngioJet procedures for a variety of thrombotic conditions. Patient demographics, procedural information, outcome data, and safety information were collected through 3 months postprocedure on AngioJet procedures. This paper describes the data collected for subjects presenting with hemodialysis access thrombosis.
  
  
  RESULTS
  A total of 72 (16%) of the 452 subjects enrolled in the PEARL 1 Registry had thrombosed hemodialysis access sites. Procedural success was reported in 66/72 subjects (92%); surgical interventions were required in 6/72 subjects (8%). There was a statistically significant improvement (p<0.0001) in vessel occlusion from baseline to final angiography. Eighty-eight percent of access sites were patent at the end of the procedure and 97% of vessels showed improved occlusion status of =1 grades. Among prosthetic grafts, 53% (20/38) remained patent at the 3-month follow-up, 18% (7/38) were restenosed, and 29% (11/38) rethrombosed. Among autologous fistulas, 86% (18/21) remained patent without intervention at the 3-month follow-up; 3 fistulas rethrombosed. Four subjects (5%) died; none of the deaths were considered related to the AngioJet device or procedure.
  
  
  CONCLUSIONS
  Outcomes from the PEARL I registry corroborate other studies of AngioJet thrombectomy and the overall literature of endovascular thrombectomy procedures. A high procedural success rates with acceptable near-term patency rates and low rates of adverse events are achieved with AngioJet thrombectomy.
authors.affiliation: Penn State University, 500 University Drive, 17033 Hershey, PA, USA. esimoni@hmc.psu.edu
authors.forename: Eugene
authors.initials: E
authors.lastname: Simoni
authors.forename: Lawrence
authors.initials: L
authors.lastname: Blitz
authors.forename: Robert
authors.initials: R
authors.lastname: Lookstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical; D015331:Cohort Studies; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D006435:Renal Dialysis / Q000295:instrumentation*; D017131:Thrombectomy / Q000295:instrumentation*; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D062666:Vascular Access Devices