Abstract
Abstract Background and Aims Though tunneled cuffed catheters (TCCs) are frequently inserted for treating thrombotic malfunction, it is unclear whether such exchanges are associated with an increased risk of pulmonary embolism (PE). This study sought to investigate the incidence of PE among patients with hemodialysis catheter- related right atrial thrombosis (CRAT). Method We conducted a retrospective cohort study on 180 hemodialysis (HD) patients treated in the West China Hospital with a diagnosis of CRAT between May 2018 and March 2020. All cases with CRAT were treated with catheter replacements (guidewire exchange or insertion at new sites) and the tip of new catheters were adjusted to be away from the original position and close to the right atrial. Antiplatelet therapy was started after the surgery with dipyridamole. All patients maintained routine hemodialysis without any thrombolysis or thrombectomy.We investigated the PE incidence and mortality among them. Results Of the 180 patients undergoing catheter replacement and with CART, 10 patients had asymptomatic PEs pre-operation and 3 additional patients developed PE post-operation. During follow-up, two patients died of pneumonia and acute myocardial infarction, respectively, but no patients died due to PE or other thrombosis complications. Conclusion The incidence of PE among HD patients with CRAT is low (5.6%), and there does not appear to exist an elevated risk of fatal PE. Combined catheter.
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