Pros & Cons of the Argon Cleaner Thrombectomy System for Dialysis Access Declots

[Chris Beck]
One of the things that I do like about the Cleaner that maybe some other thrombectomy systems are lacking is that it's got some body to it and it's also got some directionality. Just by kind of changing how much of the Cleaner is exposed, you can kind of get some directionality to the Cleaner.

For me, that's one of the things I really liked about it is that I found it easier to navigate. Sometimes if you find yourself in a stick-site fistula and if you're not dealing with an over the wire system but you have the Cleaner, you can kind of direct it towards the outflow of the fistula, which I find helpful...

You got any tips or tricks as far as how to maximize or optimize the use of the Cleaner? Like do you use the side port at all, massage the fistula at all?

[Sabeen Dhand]
Yeah, that second point I was gonna say, I use [massage] fistula. You can feel the Cleaner actually working under your hand and you know that you're getting that wall apposition. As far as tips, again, unsheathing trick if you're worried about not being able to advance it through a fistula circuit. I think it's generally very easy to use, straight forward and, again, atraumatic so you're not going to have any problems.

Someone had suggested to me using a Cleaner through an aspiration catheter, and eight french aspiration catheter, that could maybe increase it's utility, but I haven't tried that.

[Sabeen Dhand]
The only thing I can think of that's negative, what I have to deal with in the Cleaner, is that it's not over the wire. In some instances when you have a really tough venous anastomosis, you do have to bail on your wire access and when I'm doing that I can get a little bit worried.

I do like that it comes in six and seven french, I feel the seven french system I'll use too. Usually I use the six french, but I'll use the seven french system if I have a pseudo aneurysmal fistula. I feel like it gets me better wall apposition. It works well, the only [negative] thing would be the wire, the loss of wire access.

[Chris Beck]
Now, I get Sabeen's point in that I think most of us, it's just inherent that you want something over the wire; it feels very stable, it feels very safe...Most of the time [when] I'm using it, I've already gotten wire access so I've got to pull it and then start running the Cleaner though.

[Sabeen Dhand]
Yeah. No, I'm doing that too. Then sometimes if I have to - a little twist I'll use a longer sheath and I'll pin-pull the Cleaner out and I'll pull it back while I'm making the milkshake.