title: Clinical Experience with a Hybrid Procedure Using the Adherent Clot Catheter for Salvage of Thrombosed Hemodialysis Access: A Comparison with the Standard Fogarty Balloon Catheter.
abstract: OBJECTIVE
  This study aimed to compare the efficacy of two different catheters in hybrid surgery for salvage of thrombosed hemodialysis accesses.
  
  
  METHODS
  The hybrid salvage procedure (surgical thrombectomy followed by endovascular angioplasty) of the thrombosed hemodialysis access, was performed using adherent clot (AC) catheter in 140 cases and Fogarty balloon catheter in 68 cases. Procedure-related outcomes such as the clot removal status, clinical success, complications, and primary patency rates were analyzed retrospectively.
  
  
  RESULTS
  The proportion of cases with good clot removal scores in the AC catheter and Fogarty balloon catheter groups was 77.9% and 91.2%, respectively (P=0.018). Clinical success was achieved in 90.7% of the cases in the AC catheter group and in 98.5% of the cases in the balloon catheter group (P=0.035). The mean patency rates of the two groups were 50.7% and 63.2% at 3 months, 40.7% and 47.1% at 6 months, and 17.9% and 19.1% at 12 months. The complication rates (12.1% and 5.9%) and primary patency rates between the two catheters were not statistically different (P=0.328). On the analysis of the patency rate on access type of autologous (P=0.169) and prothetic graft (P=0.423), there was no significant difference between the two catheter groups.
  
  
  CONCLUSIONS
  In terms of clot removal and clinical success, the AC catheter did not demonstrate better outcomes than the Fogarty balloon catheter. However, primary patency was not related to the type of catheter. Adherent clot catheter can be a useful alternative to Fogarty balloon catheter for thrombosed hemodialysis access.
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Presbyterian Medical Center, University of Seonam College of Medicine, Jeonju, Korea.
authors.forename: Yu Sung
authors.initials: YS
authors.lastname: Yang
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Presbyterian Medical Center, University of Seonam College of Medicine, Jeonju, Korea.
authors.forename: Kyu Dam
authors.initials: KD
authors.lastname: Han
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Presbyterian Medical Center, University of Seonam College of Medicine, Jeonju, Korea.
authors.forename: Eun Hye
authors.initials: EH
authors.lastname: Choi
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Presbyterian Medical Center, University of Seonam College of Medicine, Jeonju, Korea.
authors.forename: Young Sam
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Chest Surgery, Presbyterian Medical Center, University of Seonam College of Medicine, Jeonju, Korea.
authors.forename: Yeon Ho
authors.initials: YH
authors.lastname: Seo
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Presbyterian Medical Center, University of Seonam College of Medicine, Jeonju, Korea.
authors.forename: Cheol Seung
authors.initials: CS
authors.lastname: Kim
keywords: Fogarty balloon; Thrombectomy; Thrombosis; Vascular access