Percutaneous rheolytic thrombectomy of thrombosed arteriovenous dialysis access using the AngioJet catheter- A Systematic Review

The endovascular removal of thrombi in occluded arteriovenous (AV) access sites has been increasingly accepted by surgeons as an alternative to surgical thrombectomy and revision [1,2]. This systematic review documents the experiences and outcomes of using the AngioJet Rheolytic Thrombectomy Device for salvaging thrombosed arteriovenous fistulas (AVFs) or grafts (AVGs). Electronic databases, such as PubMed, Embase, and the Cochrane Library, were searched from their establishment until May 2024. Initially, 549 articles were reviewed for potential inclusion, and only 10 studies fulfilled our inclusion criteria. Our final dataset included 771 patients who underwent 996 thrombectomies to treat 338 thrombosed AVFs and 457 AVGs. The demographics, technical and procedural success, patency rates, and complications were evaluated to examine the effectiveness and safeness of AngioJet thrombectomy. The mean primary patency rates at 3, 6, and 12 months were 64.09 +- 10.12, 50.36 +- 11.73, and 40.81 +- 15.13 (p < 0.05). The mean assisted primary patency rates at 3, 6, and 12 months were 75.37 +- 13.98, 59.58 +- 14.26 and 40.88 +- 18.81 (p < 0.05). Finally, the mean secondary patency rates at 3, 6, and 12 months were 84.03+- 8.38, 77.93 +- 9.07, and 65.81 +- 12.12 (p < 0.05). A total of 92 complications were recorded; most were minor complications, thereby being transient and self-limiting. Additionally, 5 total deaths were reported; however, all were not considered related to the AngioJet device. Our study deemed devices such as AngioJet efficacious in performing pharmacomechanical thrombectomies, as promising results in terms of safeness and effectiveness to re-establish patency in occluded AVFs and AVGs have been reported. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement No funding was provided ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors