Ep. 420 The Art and Science of Declotting the Dialysis Circuit with Dr. Omar Chohan and Dr. Harris Chengazi

BackTable Vascular & Interventional

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.

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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SHOW NOTES

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

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RESOURCES

BackTable Declot Guide:

https://www.backtable.com/shows/vi/topics/procedure/declot

BackTable VI Episode #25 - Declots with the Argon Cleaner Device with Dr. Sabeen Dhand:

https://www.backtable.com/shows/vi/podcasts/25/declots-with-the-argon-cleaner-device

BackTable VI Episode #117 - Successful (and Quick!) Declots for AV Access with Dr. Neghae Mawla:

https://www.backtable.com/shows/vi/podcasts/117/successful-quick-declots-for-av-access

BackTable VI Episode #139 - AV Fistula & Graft Maintenance with Dr. Ari Kramer:

https://www.backtable.com/shows/vi/podcasts/139/av-fistula-graft-maintenance

BackTable VI Episode #141 - DEB vs. Balloon Angioplasty Alone for Dysfunctional Hemodialysis Access with Dr. Eric Therasse:

https://www.backtable.com/shows/vi/podcasts/141/deb-vs-balloon-angioplasty-alone-for-dysfunctional-hemodialysis-access

BackTable VI Episode #292 - Dialysis Interventions with Drug-Coated Balloons, Covered Stents and More Dr. Ari Kramer:

https://www.backtable.com/shows/vi/podcasts/292/dialysis-interventions-with-drug-coated-balloons-covered-stents-more