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Endovascular treatment of arteriovenous graft dysfunction as a result of graft delamination and fracture.
Chaurasia, Aditi; Garg, Tushar; Ahuja, Rakesh; Ferra, Michael.
  • Chaurasia A; Department of Radiodiagnosis, All India Institute of Medical Sciences Bhopal, Bhopal, India. adi5974@gmail.com.
  • Garg T; Department of Interventional Radiology, Seth GS Medical College & KEM Hospital, Mumbai, India.
  • Ahuja R; Department of Radiology - Division of Vascular and Interventional Radiology, Einstein Medical Center, Philadelphia, USA.
  • Ferra M; Department of Radiology - Division of Vascular and Interventional Radiology, Einstein Medical Center, Philadelphia, USA.
CVIR Endovasc ; 4(1): 1, 2021 Jan 02.
Article in English | MEDLINE | ID: covidwho-1004363
ABSTRACT

BACKGROUND:

Graft thrombosis due to fabric delamination is a rare cause of delayed failure of arteriovenous grafts. Graft delamination is primarily an imaging diagnosis and is confirmed with the help of ultrasound which shows the separation of graft fabric layers. Only two such cases have been described in the literature so far. CASE PRESENTATION We present a case of upper extremity arteriovenous graft thrombosis in a 79 year old COVID-19 positive patient with end-stage renal disease. The diagnosis was established on ultrasonography which revealed separation of the graft fabric layers with thrombosis within the "false" and "true" lumen of the graft. The patient was managed with angioplasty and embolectomy of the clot material followed by stent-graft placement across the delaminated portion of the graft. Post-procedural angiography confirmed brisk flow across the graft and patient could successfully have subsequent hemodialysis sessions.

CONCLUSIONS:

Identification of graft delamination as a cause of graft failure is important as its management differs from other conventional causes since it requires stent-grafts to cover the area of delamination to re-establish flow and salvage the AV graft. The recognition of this phenomenon is essential to provide quality care and successful reuse of the AV graft. LEVEL OF EVIDENCE Level 4, Case Report.
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Full text: Available Collection: International databases Database: MEDLINE Language: English Journal: CVIR Endovasc Year: 2021 Document Type: Article Affiliation country: S42155-020-00181-8

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Full text: Available Collection: International databases Database: MEDLINE Language: English Journal: CVIR Endovasc Year: 2021 Document Type: Article Affiliation country: S42155-020-00181-8