Pulmonary Hypertension in Hemodialysis Patients Following Repeated Endovascular Thrombectomy.
BACKGROUND
The prevalence of pulmonary hypertension is unusually high in Taiwanese patients with end-stage renal disease. Thrombosis of hemodialysis grafts is common and pulmonary embolism has been reported after endovascular thrombectomy. The aim of this study was to evaluate the relationship between pulmonary hypertension and endovascular thrombectomy of hemodialysis grafts.


METHODS
One hundred and ten patients on hemodialysis via arteriovenous grafts were enrolled in our study. The mean pulmonary artery pressure (PAP) was measured by right heart catheterization. Clinical information was collected by review of medical records. Comorbid cardiopulmonary disease was evaluated by echocardiography and chest X-ray. The history of patient vascular access thrombosis was reviewed from database, hemodialysis records, and interviews with staff at hemodialysis centers.


RESULTS
Fifty-two participants (47%) had pulmonary hypertension diagnosed by right heart catheterization. There was no difference in the number of thrombectomy procedures between patients with and without pulmonary hypertension. Based on multivariate analysis, the number of prior endovascular thrombectomy procedures did not correlate with mean PAP (F-value = 1.10, p = 0.30) nor was it associated with pulmonary hypertension (odds ratio = 0.92, p = 0.17).


CONCLUSIONS
Prior endovascular arteriovenous graft thrombectomies were not associated with pulmonary hypertension or increased mean PAP in end-stage renal disease patients on maintenance hemodialysis.
Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu;
Mu-Yang
MY
Hsieh
Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu;
Lin
L
Lin
Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu;
Tsung-Yan
TY
Chen
Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu;
Ren-Huei
RH
Wang
Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu;
Su-Chin
SC
Huang
Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu;
HsiuChiao
H
Liu
Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu; ; College of Medicine, National Taiwan University, Taipei; ; Department of Internal Medicine and Center for Critical Care Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu; ; Department of Internal Medicine, College of Medicine; ; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei;
Chao-Lun
CL
Lai
Cardiology Department, Ton-Yen General Hospital, Hsinchu;
Shih-Yen
SY
Pu
Cardiology Department, Miaoli General Hospital, Miaoli;
Kuei-Chin
KC
Tsai
Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu; ; College of Medicine, National Taiwan University, Taipei; ; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Chih-Cheng
CC
Wu
Graft; Hemodialysis; Pulmonary hypertension; Thrombectomy; Thrombosis