Thrombectomy is a common procedure for maintenance of arteriovenous (AV) access and is critical to prolong access life. Techniques for performing thrombectomy are incredibly diverse, ranging from open surgical procedures to percutaneous interventions. Percutaneous interventions include a combination of thrombectomy devices to clear the thrombus and balloon angioplasty to treat the underlying lesion. In this case report we describe a novel technique using a single device, the Chameleon™ PTA balloon catheter (Medtronic, Minneapolis, MN) balloon catheter, to safely and efficiently perform a percutaneous intervention.
United States Renal Data System. 2018 USRDS annual data report: epidemiology of kidney disease in the United States. Bethesda, MD: National Institutes of Health; National Institute of Diabetes and Digestive and Kidney Diseases, 2018.
2.
LokCEHuberTSLeeT, et al. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis2020; 75(4 Suppl. 2): S1–S164.
3.
FeldmanHIKobrinSWassersteinA.Hemodialysis vascular access morbidity. J Am Soc Nephrol1996; 7: 523–535.
4.
RoccoMVBleyerAJBurkartJM.Utilization of inpatient and outpatient resources for the management of hemodialysis access complications. Am J Kidney Dis1996; 28: 250–256.
5.
QuencerKBFriedmanT.Declotting the thrombosed access. Tech Vasc Interv Radiol2017; 20(1): 38–47.
6.
DariushniaSRWalkerTGSilberzweigJE, et al. Quality improvement guidelines for percutaneous image-guided management of the thrombosed or dysfunctional dialysis circuit. J Vasc Interv Radiol2016; 27(10): 1518–1530.
7.
KitrouPMPapadimatosPSpiliopoulosS, et al. Lysis-assisted balloon (LAB) thrombectomy. A declotting technique for the treatment of thrombosed arteriovenous dialysis grafts. 5-year experience of 241 endovascular procedures. Cardiovasc Intervent Radiol2018; 41: 245–252.
8.
KitrouPMKatsanosKPapadimatosP, et al. A survival guide for endovascular declotting in dialysis access: procedures, devices, and a statistical analysis of 3,000 cases. Expert Rev Med Devices2018; 15(4): 283–291.
9.
CrawfordJKokkosisAKimP, et al. Fistuloplasty using a radiation-and-time-saving sheathless balloon catheter. J Vasc Access2019; 20(3): 276–280.
10.
YevzlinAS.On the retrograde occlusive arteriogram. Semin Dial2009; 22(6): 702–703.
11.
SalmanLAsifABeathardGA.Retrograde angiography and the risk of arteriovenous fistula perforation. Semin Dial2009; 22(6): 698–701.
12.
CrawfordJGasparisAKimP, et al. Procedural comparison of a standard PTA balloon for fistula and graft maintenance procedures with the novel Chameleon™ PTA balloon catheter. J Vasc Access. Epub ahead of print 15 December 2020. DOI: 10.1177/1129729820979479.
13.
WangALaiK.The importance of residual renal function in dialysis patients. Kidney Int2006; 69(10): 1726–1732.
14.
ChanMRChhokarVSYoungHN, et al. Retrograde occlusive arteriography of hemodialysis access: failure to detect inflow lesions?Semin Dial2011; 24(4): 452–455.
15.
SchonDDeLozierTPatelN.Comparison of procedure cost for thrombectomy of arteriovenous fistulas and grafts. Semin Dial2013; 26(3): 344–348.
