title: Impact on pulmonary arterial pressures after repeated endovascular thrombectomy of dialysis grafts: a prospective follow-up study.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Cardiology Division, National Taiwan University Hospital Hsinchu Branch, No. 25, Lane 442, Sec. 1, Jingguo Rd., Hsinchu City 300, Taiwan.
authors.forename: Mu-Yang
authors.initials: MY
authors.lastname: Hsieh
authors.affiliation: Cardiology Division, National Taiwan University Hospital Hsinchu Branch, No. 25, Lane 442, Sec. 1, Jingguo Rd., Hsinchu City 300, Taiwan; College of Medicine, National Taiwan University, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Chao-Lun
authors.initials: CL
authors.lastname: Lai
authors.affiliation: School of Medicine, National Yang-Ming University, Far Eastern Memorial Hospital, Taipei, Taiwan; Nuclear Medicine and Cardiovascular Center, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Yen-Wen
authors.initials: YW
authors.lastname: Wu
authors.affiliation: Cardiology Division, National Taiwan University Hospital Hsinchu Branch, No. 25, Lane 442, Sec. 1, Jingguo Rd., Hsinchu City 300, Taiwan.
authors.forename: Lin
authors.initials: L
authors.lastname: Lin
authors.affiliation: Nursing Department, National Taiwan University Hospital Hsinchu Branch, No. 25, Lane 442, Sec. 1, Jingguo Rd., Hsinchu City 300, Taiwan.
authors.forename: Miao-Chun
authors.initials: MC
authors.lastname: Ho
authors.affiliation: Cardiology Division, National Taiwan University Hospital Hsinchu Branch, No. 25, Lane 442, Sec. 1, Jingguo Rd., Hsinchu City 300, Taiwan; College of Medicine, National Taiwan University, Far Eastern Memorial Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Far Eastern Memorial Hospital, Taipei, Taiwan. Electronic address: chihchengwumd@gmail.com.
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Wu
mesh_terms: D000368:Aged; D062186:Arterial Pressure / Q000502:physiology*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000601:surgery*; D011655:Pulmonary Embolism / Q000601:surgery*; D006435:Renal Dialysis / Q000295:instrumentation*; D017131:Thrombectomy / Q000379:methods*