Episode # 420 • 27 Feb 2024
The Art & Science of Declotting the Dialysis Circuit
In this episode of the Backtable Podcast, host Dr. Chris Beck interviews guests Dr. Omar Chohan and Dr. Harris Chengazi about dialysis fistula declot procedures and their own experiences with various devices and strategies, including usage of pre-procedure ultrasound, heparinization, and closure techniques. Both Dr. Chohan and Dr. Chengazi are interventional radiologists at Great Lakes Medical Imaging in Buffalo, New York.
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Timestamps
00:00 - Introduction
05:59 - Importance of Problem Solving in Declot Procedures
07:27 - Role of Pre-Procedure Ultrasound
12:00 - Process of Declot Procedures
28:27 - Moving to the Arterial Side: Access and Treatment
32:37 - Wire Management and the Risk of Rupture
41:59 - Art of Closure: Techniques and Considerations
45:53 - When to Quit: Evaluating the Need for Revision or Alternative Treatment
50:24 - Experience and Planning in Successful Fistula Treatment
Resources
- BackTable Declot Guide
- BackTable VI Episode #25 - Declots with the Argon Cleaner Device with Dr. Sabeen Dhand
- BackTable VI Episode #117 - Successful (and Quick!) Declots for AV Access with Dr. Neghae Mawla
- BackTable VI Episode #139 - AV Fistula & Graft Maintenance with Dr. Ari Kramer
- BackTable VI Episode #141 - DEB vs. Balloon Angioplasty Alone for Dysfunctional Hemodialysis Access with Dr. Eric Therasse
- BackTable VI Episode #292 - Dialysis Interventions with Drug-Coated Balloons, Covered Stents and More Dr. Ari Kramer
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More about this episode
The doctors dive into treatment of anastomosis stenosis, stressing the importance of technique refinement, physical examination, and thoughtful pre-procedure planning. The discussion concludes with an invitation for listeners to share their experiences with the ‘bottle-cap’ hemostasis trick.
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