INTERVENTIONAL RADIOLOGY MANAGEMENT OF HEMODIALYSIS ACCESS-RELATED PROBLEMS - THE USE OF MECHANICAL THROMBECTOMY DEVICES

Hemodialysis centers are increasingly utilizing the interventional rad iologist to manage and treat hemodialysis access-related problems. Usi ng a variety of endovascular tools and techniques, the interventional radiologist can provide several important services for the management of vascular access problems, including: 1) the early detection of sten osis developing within the graft or native veins, 2) the repair of mal functioning grafts or central venous catheters, and 3) restoration of blood flow to thrombosed hemodialysis grafts. A new type of endovascul ar tool, the mechanical thrombectomy device, has proven to be useful f or quickly and effectively removing thrombus from an acutely occluded vascular access. This article will review the indications for using a mechanical thrombectomy device and describe a variety of the technique s that interventional radiologists use for restoring bloodflow to a th rombosed hemodialysis graft.