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

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. --- CHECK OUT OUR SPONSOR Argon Cleaner Rotational Thrombectomy System https://www.argonmedical.com/cleaner --- 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 --- 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