Impact on pulmonary arterial pressures after repeated endovascular thrombectomy of dialysis grafts: A prospective follow-up study
Journal
Journal of Vascular and Interventional Radiology
Journal Volume
25
Journal Issue
12
Pages
1883-1889
Date Issued
2014
Author(s)
Abstract
Purpose Vascular access thrombosis is a common complication of arteriovenous dialysis grafts that results in silent pulmonary embolism (PE) in a substantial proportion of patients. However, the impact of repeated PE on the pulmonary vasculature remains unclear.Materials and Methods From January 2010 to April 2012, 110 patients undergoing maintenance hemodialysis via arteriovenous grafts were recruited. Hemodynamic assessments, including transthoracic echocardiography and right heart catheterization, were performed at baseline and after 1 year to evaluate the changes in pulmonary artery (PA) pressures and heart function.Results Fifty-two patients completed the follow-up hemodynamic assessment at a median duration of 535 days and had at least one endovascular thrombectomy procedure (median of seven). There was no significant difference in mean PA pressures between baseline and the end of follow-up (23.1 mm Hg ± 6.8 vs 21.6 mm Hg ± 6.1; P =.16). The change in mean PA pressure did not correlate with the number of thrombectomy procedures in the overall cohort (r = -0.02, P =.89) or in the subgroup with cardiopulmonary disease (r = -0.30, P =.14). The changes of mean PA pressure were not associated with number of thrombectomy procedures (β = -0.03, P =.89).Conclusions Repeated endovascular thrombectomy procedures are not related to changes in PA pressure in the short term. The present results support the safety of endovascular thrombectomy in the pulmonary vasculature. ? 2014 SIR.
SDGs
Other Subjects
heparin; aged; anticoagulant therapy; Article; central venous catheter; clinical assessment; cohort analysis; controlled study; dialysis graft; female; follow up; graft infection; heart catheterization; heart function; hemodialysis; hemodynamics; human; lung artery pressure; lung blood vessel; maintenance therapy; major clinical study; male; mechanical thrombectomy; prospective study; pulmonary artery; pulmonary hypertension; reoperation; thrombectomy device; thrombus; transthoracic echocardiography; adverse effects; arterial pressure; arteriovenous shunt; devices; endovascular surgery; Graft Occlusion, Vascular; physiology; procedures; Pulmonary Embolism; renal replacement therapy; thrombectomy; Aged; Arterial Pressure; Arteriovenous Shunt, Surgical; Endovascular Procedures; Female; Follow-Up Studies; Graft Occlusion, Vascular; Humans; Male; Prospective Studies; Pulmonary Artery; Pulmonary Embolism; Renal Dialysis; Thrombectomy
Type
journal article