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Thomas M. Vesely - One of the best experts on this subject based on the ideXlab platform.
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comparison of the angiojet rheolytic catheter to Surgical Thrombectomy for the treatment of thrombosed hemodialysis grafts
Journal of Vascular and Interventional Radiology, 2000Co-Authors: Thomas M. Vesely, David R Williams, Mark Weiss, Marshall E Hicks, Brian F Stainken, Terence A S Matalon, Bart DolmatchAbstract:Purpose To compare the clinical effectiveness of the AngioJet F105 rheolytic catheter to that of Surgical Thrombectomy for the treatment of thrombosed hemodialysis grafts. Materials and Methods This was a multicenter, prospective, randomized trial comparing technical success, primary patency, and complication rates. A total of 153 patients were enrolled: 82 patients in the AngioJet group and 71 patients in the Surgical Thrombectomy group. Patient follow-up was performed 24–48 hours, 1 month, and 6 months after the procedures. Results Technical success, as defined by the patient's ability to undergo hemodialysis treatment, was 73.2% for the AngioJet group and 78.8% for the Surgical Thrombectomy group (P = .41). The primary patency rates of the AngioJet group were 32%, 21%, and 15% at 1, 2, and 3 months, respectively. The primary patency rates for the Surgical group were 41%, 32%, and 26% at 1, 2, and 3 months, respectively. This difference approached statistical significance (P = .053). The groups had similar complication rates—14.6% in the AngioJet group and 14.1% in the surgery group—although the surgery group had more major complications (11.3%). In the AngioJet group, there was a transient increase in plasma-free hemoglobin, which normalized within 24–48 hours. Conclusions The AngioJet F105 catheter provides similar clinical results when compared to Surgical Thrombectomy for the treatment of thrombosed hemodialysis grafts. The difference in patency rates between these two techniques approached statistical significance. In addition, results of both Thrombectomy methods were inferior to those suggested by the Dialysis Outcomes Quality Initiative guidelines.
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Dialysis InterventionComparison of the AngioJet Rheolytic Catheter to Surgical Thrombectomy for the Treatment of Thrombosed Hemodialysis Grafts
Journal of vascular and interventional radiology : JVIR, 1999Co-Authors: Thomas M. Vesely, David R Williams, Mark Weiss, Marshall E Hicks, Brian F Stainken, Terence A S Matalon, Bart DolmatchAbstract:Purpose To compare the clinical effectiveness of the AngioJet F105 rheolytic catheter to that of Surgical Thrombectomy for the treatment of thrombosed hemodialysis grafts. Materials and Methods This was a multicenter, prospective, randomized trial comparing technical success, primary patency, and complication rates. A total of 153 patients were enrolled: 82 patients in the AngioJet group and 71 patients in the Surgical Thrombectomy group. Patient follow-up was performed 24–48 hours, 1 month, and 6 months after the procedures. Results Technical success, as defined by the patient's ability to undergo hemodialysis treatment, was 73.2% for the AngioJet group and 78.8% for the Surgical Thrombectomy group (P = .41). The primary patency rates of the AngioJet group were 32%, 21%, and 15% at 1, 2, and 3 months, respectively. The primary patency rates for the Surgical group were 41%, 32%, and 26% at 1, 2, and 3 months, respectively. This difference approached statistical significance (P = .053). The groups had similar complication rates—14.6% in the AngioJet group and 14.1% in the surgery group—although the surgery group had more major complications (11.3%). In the AngioJet group, there was a transient increase in plasma-free hemoglobin, which normalized within 24–48 hours. Conclusions The AngioJet F105 catheter provides similar clinical results when compared to Surgical Thrombectomy for the treatment of thrombosed hemodialysis grafts. The difference in patency rates between these two techniques approached statistical significance. In addition, results of both Thrombectomy methods were inferior to those suggested by the Dialysis Outcomes Quality Initiative guidelines.
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Thrombolysis versus Surgical Thrombectomy for the Treatment of Dialysis Graft Thrombosis: Pilot Study Comparing Costs
Journal of vascular and interventional radiology : JVIR, 1996Co-Authors: Thomas M. Vesely, Mary C. Idso, Jean Audrain, David W. Windus, Jeffrey A. LowellAbstract:Purpose This preliminary investigation was designed to compare the cost of pharmacomechanical thrombolysis and angioplasty with that of Surgical Thrombectomy for the treatment of thrombosed hemodialysis grafts. Patients and Methods This prospective, randomized study consisted of 20 patients with unrevised, polytetrafluoroethylene forearm dialysis grafts of similar configuration in which graft thrombosis occurred for the first time. Ten patients underwent pulse-spray thrombolysis plus angioplasty, and 10 patients underwent Surgical Thrombectomy. The technical costs, professional fees, and all other associated costs were obtained. Procedural data, graft patency rates, and demographic information were analyzed. Results The technical success rate was 70% for thrombolysis and 80% for Surgical Thrombectomy. The duration of patency, including the technical failures, was 81.6 days for thrombolysis and 93.9 days for surgery. For the thrombolysis and angioplasty procedure, the median technical cost was $2,906 and the median professional fee was $3,156 for a median total cost of $6,062. The median technical cost for Surgical Thrombectomy was $2,449 and the median Surgical fee was $2,100, but these patients incurred an additional anesthesia fee (median, $1,031) bringing the total median cost to $5,580. Conclusions These two competing procedures were comparable in cost, and the technical success and patency rates were also similar.
T Hummel - One of the best experts on this subject based on the ideXlab platform.
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Surgical Thrombectomy for iliofemoral deep vein thrombosis patient outcomes at 8 5 years
PLOS ONE, 2020Co-Authors: Dominic Muhlberger, Martin Wenkel, Georg Papapostolou, A Mumme, M Stucker, Stefanie Reichschupke, T HummelAbstract:Introduction Deep vein thrombosis (DVT) is a frequent burden and a post-thrombotic syndrome (PTS) can be a serious long-term consequence. Iliofemoral DVT should be associated with severe forms of PTS. Therefore an early thrombus removal has been recommended in specific conditions. The aim of this study was to find out both, the long-term results after Surgical Thrombectomy of iliofemoral DVT in respect of the development of PTS as well as the venous hemodynamics after surgery concerning venous reflux and venous obstruction. Methods Sixty-seven patients who underwent Surgical Thrombectomy between the years 2000 and 2014 were included in this study; iliofemoral DVT was present in 52 of these patients. 35 patients could be reinvestigated after a mean follow-up of 8.5 years. CEAP (Clinical-Etiological-Anatomical-Pathophysiological) and Villalta scores were recorded in order to describe and assess PTS. Follow-up examinations included a detailed duplex mapping. Venous hemodynamics were measured by digital photoplethysmography and venous occlusion plethysmography. Results The primary patency rate of the iliofemoral segment was 88% after 8.5 years. 48% of all patients showed reflux in deep vein segments. Mild or moderate PTS occurred in 57% of all patients. Notably, there was no patient with an active ulcer or severe PTS. The mean venous outflow volume of all patients in the treated legs was 66.1 ml/100ml/min and significantly less than in the controlled contralateral non-treated legs (p<0.05). The mean venous refilling time was 16.3 seconds, while the mean value of the non-treated contralateral legs was 25.6 seconds and therefore significantly higher (p<0.05). Conclusion Even though venous hemodynamics are significantly inferior in the treated legs, this study demonstrates excellent patency rates and good clinical outcome after Surgical Thrombectomy of iliofemoral veins.
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Surgical Thrombectomy for iliofemoral deep vein thrombosis: Patient outcomes at 8.5 years
PloS one, 2020Co-Authors: Dominic Muhlberger, Martin Wenkel, Georg Papapostolou, A Mumme, M Stucker, Stefanie Reich-schupke, T HummelAbstract:Introduction Deep vein thrombosis (DVT) is a frequent burden and a post-thrombotic syndrome (PTS) can be a serious long-term consequence. Iliofemoral DVT should be associated with severe forms of PTS. Therefore an early thrombus removal has been recommended in specific conditions. The aim of this study was to find out both, the long-term results after Surgical Thrombectomy of iliofemoral DVT in respect of the development of PTS as well as the venous hemodynamics after surgery concerning venous reflux and venous obstruction. Methods Sixty-seven patients who underwent Surgical Thrombectomy between the years 2000 and 2014 were included in this study; iliofemoral DVT was present in 52 of these patients. 35 patients could be reinvestigated after a mean follow-up of 8.5 years. CEAP (Clinical-Etiological-Anatomical-Pathophysiological) and Villalta scores were recorded in order to describe and assess PTS. Follow-up examinations included a detailed duplex mapping. Venous hemodynamics were measured by digital photoplethysmography and venous occlusion plethysmography. Results The primary patency rate of the iliofemoral segment was 88% after 8.5 years. 48% of all patients showed reflux in deep vein segments. Mild or moderate PTS occurred in 57% of all patients. Notably, there was no patient with an active ulcer or severe PTS. The mean venous outflow volume of all patients in the treated legs was 66.1 ml/100ml/min and significantly less than in the controlled contralateral non-treated legs (p
Bart Dolmatch - One of the best experts on this subject based on the ideXlab platform.
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comparison of the angiojet rheolytic catheter to Surgical Thrombectomy for the treatment of thrombosed hemodialysis grafts
Journal of Vascular and Interventional Radiology, 2000Co-Authors: Thomas M. Vesely, David R Williams, Mark Weiss, Marshall E Hicks, Brian F Stainken, Terence A S Matalon, Bart DolmatchAbstract:Purpose To compare the clinical effectiveness of the AngioJet F105 rheolytic catheter to that of Surgical Thrombectomy for the treatment of thrombosed hemodialysis grafts. Materials and Methods This was a multicenter, prospective, randomized trial comparing technical success, primary patency, and complication rates. A total of 153 patients were enrolled: 82 patients in the AngioJet group and 71 patients in the Surgical Thrombectomy group. Patient follow-up was performed 24–48 hours, 1 month, and 6 months after the procedures. Results Technical success, as defined by the patient's ability to undergo hemodialysis treatment, was 73.2% for the AngioJet group and 78.8% for the Surgical Thrombectomy group (P = .41). The primary patency rates of the AngioJet group were 32%, 21%, and 15% at 1, 2, and 3 months, respectively. The primary patency rates for the Surgical group were 41%, 32%, and 26% at 1, 2, and 3 months, respectively. This difference approached statistical significance (P = .053). The groups had similar complication rates—14.6% in the AngioJet group and 14.1% in the surgery group—although the surgery group had more major complications (11.3%). In the AngioJet group, there was a transient increase in plasma-free hemoglobin, which normalized within 24–48 hours. Conclusions The AngioJet F105 catheter provides similar clinical results when compared to Surgical Thrombectomy for the treatment of thrombosed hemodialysis grafts. The difference in patency rates between these two techniques approached statistical significance. In addition, results of both Thrombectomy methods were inferior to those suggested by the Dialysis Outcomes Quality Initiative guidelines.
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Dialysis InterventionComparison of the AngioJet Rheolytic Catheter to Surgical Thrombectomy for the Treatment of Thrombosed Hemodialysis Grafts
Journal of vascular and interventional radiology : JVIR, 1999Co-Authors: Thomas M. Vesely, David R Williams, Mark Weiss, Marshall E Hicks, Brian F Stainken, Terence A S Matalon, Bart DolmatchAbstract:Purpose To compare the clinical effectiveness of the AngioJet F105 rheolytic catheter to that of Surgical Thrombectomy for the treatment of thrombosed hemodialysis grafts. Materials and Methods This was a multicenter, prospective, randomized trial comparing technical success, primary patency, and complication rates. A total of 153 patients were enrolled: 82 patients in the AngioJet group and 71 patients in the Surgical Thrombectomy group. Patient follow-up was performed 24–48 hours, 1 month, and 6 months after the procedures. Results Technical success, as defined by the patient's ability to undergo hemodialysis treatment, was 73.2% for the AngioJet group and 78.8% for the Surgical Thrombectomy group (P = .41). The primary patency rates of the AngioJet group were 32%, 21%, and 15% at 1, 2, and 3 months, respectively. The primary patency rates for the Surgical group were 41%, 32%, and 26% at 1, 2, and 3 months, respectively. This difference approached statistical significance (P = .053). The groups had similar complication rates—14.6% in the AngioJet group and 14.1% in the surgery group—although the surgery group had more major complications (11.3%). In the AngioJet group, there was a transient increase in plasma-free hemoglobin, which normalized within 24–48 hours. Conclusions The AngioJet F105 catheter provides similar clinical results when compared to Surgical Thrombectomy for the treatment of thrombosed hemodialysis grafts. The difference in patency rates between these two techniques approached statistical significance. In addition, results of both Thrombectomy methods were inferior to those suggested by the Dialysis Outcomes Quality Initiative guidelines.
Dominic Muhlberger - One of the best experts on this subject based on the ideXlab platform.
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Surgical Thrombectomy for iliofemoral deep vein thrombosis patient outcomes at 8 5 years
PLOS ONE, 2020Co-Authors: Dominic Muhlberger, Martin Wenkel, Georg Papapostolou, A Mumme, M Stucker, Stefanie Reichschupke, T HummelAbstract:Introduction Deep vein thrombosis (DVT) is a frequent burden and a post-thrombotic syndrome (PTS) can be a serious long-term consequence. Iliofemoral DVT should be associated with severe forms of PTS. Therefore an early thrombus removal has been recommended in specific conditions. The aim of this study was to find out both, the long-term results after Surgical Thrombectomy of iliofemoral DVT in respect of the development of PTS as well as the venous hemodynamics after surgery concerning venous reflux and venous obstruction. Methods Sixty-seven patients who underwent Surgical Thrombectomy between the years 2000 and 2014 were included in this study; iliofemoral DVT was present in 52 of these patients. 35 patients could be reinvestigated after a mean follow-up of 8.5 years. CEAP (Clinical-Etiological-Anatomical-Pathophysiological) and Villalta scores were recorded in order to describe and assess PTS. Follow-up examinations included a detailed duplex mapping. Venous hemodynamics were measured by digital photoplethysmography and venous occlusion plethysmography. Results The primary patency rate of the iliofemoral segment was 88% after 8.5 years. 48% of all patients showed reflux in deep vein segments. Mild or moderate PTS occurred in 57% of all patients. Notably, there was no patient with an active ulcer or severe PTS. The mean venous outflow volume of all patients in the treated legs was 66.1 ml/100ml/min and significantly less than in the controlled contralateral non-treated legs (p<0.05). The mean venous refilling time was 16.3 seconds, while the mean value of the non-treated contralateral legs was 25.6 seconds and therefore significantly higher (p<0.05). Conclusion Even though venous hemodynamics are significantly inferior in the treated legs, this study demonstrates excellent patency rates and good clinical outcome after Surgical Thrombectomy of iliofemoral veins.
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Surgical Thrombectomy for iliofemoral deep vein thrombosis: Patient outcomes at 8.5 years
PloS one, 2020Co-Authors: Dominic Muhlberger, Martin Wenkel, Georg Papapostolou, A Mumme, M Stucker, Stefanie Reich-schupke, T HummelAbstract:Introduction Deep vein thrombosis (DVT) is a frequent burden and a post-thrombotic syndrome (PTS) can be a serious long-term consequence. Iliofemoral DVT should be associated with severe forms of PTS. Therefore an early thrombus removal has been recommended in specific conditions. The aim of this study was to find out both, the long-term results after Surgical Thrombectomy of iliofemoral DVT in respect of the development of PTS as well as the venous hemodynamics after surgery concerning venous reflux and venous obstruction. Methods Sixty-seven patients who underwent Surgical Thrombectomy between the years 2000 and 2014 were included in this study; iliofemoral DVT was present in 52 of these patients. 35 patients could be reinvestigated after a mean follow-up of 8.5 years. CEAP (Clinical-Etiological-Anatomical-Pathophysiological) and Villalta scores were recorded in order to describe and assess PTS. Follow-up examinations included a detailed duplex mapping. Venous hemodynamics were measured by digital photoplethysmography and venous occlusion plethysmography. Results The primary patency rate of the iliofemoral segment was 88% after 8.5 years. 48% of all patients showed reflux in deep vein segments. Mild or moderate PTS occurred in 57% of all patients. Notably, there was no patient with an active ulcer or severe PTS. The mean venous outflow volume of all patients in the treated legs was 66.1 ml/100ml/min and significantly less than in the controlled contralateral non-treated legs (p
Jeffrey A. Lowell - One of the best experts on this subject based on the ideXlab platform.
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Thrombolysis versus Surgical Thrombectomy for the Treatment of Dialysis Graft Thrombosis: Pilot Study Comparing Costs
Journal of vascular and interventional radiology : JVIR, 1996Co-Authors: Thomas M. Vesely, Mary C. Idso, Jean Audrain, David W. Windus, Jeffrey A. LowellAbstract:Purpose This preliminary investigation was designed to compare the cost of pharmacomechanical thrombolysis and angioplasty with that of Surgical Thrombectomy for the treatment of thrombosed hemodialysis grafts. Patients and Methods This prospective, randomized study consisted of 20 patients with unrevised, polytetrafluoroethylene forearm dialysis grafts of similar configuration in which graft thrombosis occurred for the first time. Ten patients underwent pulse-spray thrombolysis plus angioplasty, and 10 patients underwent Surgical Thrombectomy. The technical costs, professional fees, and all other associated costs were obtained. Procedural data, graft patency rates, and demographic information were analyzed. Results The technical success rate was 70% for thrombolysis and 80% for Surgical Thrombectomy. The duration of patency, including the technical failures, was 81.6 days for thrombolysis and 93.9 days for surgery. For the thrombolysis and angioplasty procedure, the median technical cost was $2,906 and the median professional fee was $3,156 for a median total cost of $6,062. The median technical cost for Surgical Thrombectomy was $2,449 and the median Surgical fee was $2,100, but these patients incurred an additional anesthesia fee (median, $1,031) bringing the total median cost to $5,580. Conclusions These two competing procedures were comparable in cost, and the technical success and patency rates were also similar.