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Pulmonary embolism following thrombolysis of dialysis access: is anticoagulation really necessary?
MedLine Citation:
PMID:  21039878     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Vascular access thrombosis frequently complicates maintenance hemodialysis (HD) therapy. It is costly and time consuming to patients and practitioners. Alternatives to surgical thrombectomy have been developed using percutaneous thrombolysis (PT) with pharmacologic lysis, mechanical destruction of thrombus, or a combination of the two. These techniques have been used to successfully restore blood flow through thrombosed HD arteriovenous grafts (AVG), but there is a risk of dislodging thrombi into the venous circulation resulting in pulmonary embolism (PE); it is usually clinically insignificant. We examined our practice and reviewed three cases of dialysis access thrombosis treated with PT complicated by symptomatic PE. Two important questions arose: what is the risk of symptomatic PE after PT, and do patients benefit from systemic anticoagulation?
Authors:
Kellie Calderon; Kenar D Jhaveri; Robert Mossey
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in dialysis     Volume:  23     ISSN:  1525-139X     ISO Abbreviation:  Semin Dial     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-11-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8911629     Medline TA:  Semin Dial     Country:  United States    
Other Details:
Languages:  eng     Pagination:  522-5     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley Periodicals, Inc.
Affiliation:
Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore Long Island Jewish Health Systems (NS-LIJ HS) and Hofstra School of Medicine, Great Neck, New York 11021, USA. kcalderon@nshs.edu
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