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A Rapid Low-Cost Uncrossed Sheath Method for Clearing Thrombosed Hemodialysis Grafts

Edward B. Strauss1, Bradley N. Delman2 and Avelino Maitem1

1 Department of Diagnostic Radiology, Section of Interventional Radiology, Norwalk Hospital, Maple St., Norwalk, CT 06856.
2 Department of Radiology, Box 1234, Mount Sinai Medical Center, One Gustave L. Levy PI., New York, NY 10029.



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  		Fig. 1A. —Drawings illustrate schematic of uncrossed sheath method for clearing thrombosed hemodialysis grafts. Fogarty balloon is used to clear arterial anastomosis and proximal part of graft.

 


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  		Fig. 1B. —Drawings illustrate schematic of uncrossed sheath method for clearing thrombosed hemodialysis grafts. Fogarty balloon inflates occlusively within arterial side of graft; tissue plasminogen activator and heparin are injected through arterial sheath and are forced into thrombosed graft.

 


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  		Fig. 1C. —Drawings illustrate schematic of uncrossed sheath method for clearing thrombosed hemodialysis grafts. Contrast material is injected through venous sheath to treat venous stenosis with angioplasty.

 


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  		Fig. 1D. —Drawings illustrate schematic of uncrossed sheath method for clearing thrombosed hemodialysis grafts. Heparinized saline solution is injected through arterial sheath to clear liquefied thrombus from graft and native vein.

 

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