Efficacy of modified pharmacomechanic thrombolysis for endovascular treatment of thrombosed arteriovenous grafts

Objective To evaluate the efficacy and safety of the PMT technique in the treatment of thrombosed PAVA by analyzing the long-term patency.Methods Patients who were treated in our hospital for PAVA thrombosis from August 2018 to September 30,2019 were selected,and qualified patients were treated with modified pulsed-spray pharmacomechanical thrombolysis by the same surgeon.Baseline data and surgical information were collected and followed up for 180 days.Observe the postoperative patency and analyze the factors affecting the primary patency.Results A total of 105 patients underwent thrombectomy,with an average total operation time of (66.65±10.08)minutes,blood flow opening time of(16.75±4.28)minutes,and a dosage of urokinase of(27.9±8.05)ten thousand U.The technical success rate was 97.94%,and the clinical success rate 97.26%.The total complication rate was 6.85%,no symptoms pulmonary embolism and arterial embolism.The postoperative primary patency rates were 91.55%,70.42%,and 42.95% at 30,90,and 180 days,the postoperative primary assisted patency rates were 93.66%,82.39%,and 59.15%.Cox analysis showed high cholesterol (HR 1.08,P=0.02),type of vascular prosthesis (HR 2.14,P<0.01),and combined stenosis (HR 5.23,P<0.01) were the risk factors affecting the primary patency after PAVA thrombus intervention.Conclusion The modified PMT technique is effective and safe in endovascular treatment of thrombosed PAVA.It is time-saving,lower cost,simple operation,which is worthy of clinical application.