Abstract: FR-PO534
A Novel Use of JETi Thrombectomy Device Mediates Embolic Complication during Graft Thrombectomy
Session Information
- Dialysis Vascular Access
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Osorio, Luis G., Henry Ford Hospital, Detroit, Michigan, United States
- Onofrey, Kevin Thomas, Henry Ford Hospital, Detroit, Michigan, United States
- Kabbani, Loay, Henry Ford Hospital, Detroit, Michigan, United States
- Kumbar, Lalathaksha Murthy, Henry Ford Hospital, Detroit, Michigan, United States
Introduction
We present a case detailing the use of a novel thrombectomy device to treat acute upper limb ischemia as a complication of percutaneous arteriovenous graft (AVG) thrombectomy. The JETi Hydrodynamic thrombectomy System (Abbot Vascular, Abbot Park, IL) is a mechanical thrombectomy device indicated for peripheral vasculature which has demonstrated efficacy in acute venous thromboembolism1 and acute arterial limb ischemia (ALI)2.
Case Description
A 59-year-old female presented with a clotted AVG of 6-day duration. Mechanical rheolytic thromboaspiration using the Angiojet Thrombectomy system (Boston Scientific, Marlborough, MA) was performed followed by angioplasty of venous stenosis. Stenosis at arterial anastomosis was also identified and angioplastied. Completion angiogram showed patent AVG with no residual stenosis.
Completion arteriogram also revealed an embolus in the distal brachial artery with no flow distal to the occlusion. Angioplasty and Angiojet thrombectomy interventions proved unsuccessful. Subsequently, the JETi thrombectomy system was employed, leading to the successful retrieval of the clot and restoration of blood flow into the forearm.
Discussion
While arterial embolism during percutaneous thrombectomy of dialysis access is a recognized complication, it is uncommon.3 The JETi thrombectomy system integrates clot fragmentation and catheter aspiration.1 Traditionally used for deep venous thrombosis and ALI, this case exemplifies a unique utilization of the of the JETi system in managing a complication from AVG thrombectomy where more traditional methods failed.
The JETi thrombectomy system presents a promising alternative for addressing embolic complications resulting from percutaneous AVG thrombectomies and warrants consideration as a primary treatment modality. However, further studies investigating AVG thrombectomies are imperative to ascertain its suitability as a standard of care.