Thrombophilia Associated with Early Post-angioplasty Thrombosis of Dialysis Vascular Access
Percutaneous transluminal angioplasty (PTA) is widely used as the primary treatment for dialysis vascular access dysfunction. Nonetheless, many patients develop early occlusion after angioplasty. Thus, we investigated the role of thrombophilia in access occlusion within 30 days of angioplasty.
Materials and Methods
This case–control study included patients who underwent PTA for dialysis vascular access dysfunction. Patients who experienced occlusion within 30 days of angioplasty were included in the case group and those without occlusion for at least 30 days after angioplasty were included in the control group. All patients were tested for protein C, protein S, antithrombin III, lupus anticoagulant, and anticardiolipin antibodies.
From February to October 2015, 462 patients underwent PTA for dialysis vascular access dysfunction. Forty-one patients (8.9%) had early occlusion within 30 days of angioplasty. The case group had more graft accesses (73 vs. 31%, P < 0.001) and thrombotic occlusions (67 vs. 15%, P < 0.001). A higher incidence of protein C (10 vs. 2%), protein S (15 vs. 5%), and antithrombin III (10 vs. 2%) deficiency and elevated anticardiolipin antibody (22 vs. 10%) levels were observed in the case group. Overall, 26 patients (63%) in the case group had at least one thrombophilic factor, compared with 15 patients (37%) in the control group (unadjusted odds ratio [OR], 3.004; 95% confidence interval [CI], 1.223–7.380; P = 0.027). After adjustment for confounding factors, the association between thrombophilic factors and early occlusion remained (adjusted OR, 3.806; 95% CI, 1.018–14.220; P = 0.047).
Thrombophilia is associated with early occlusion after angioplasty for hemodialysis vascular access.
KeywordsThrombophilia Post-angioplasty occlusion Dialysis Vascular access
We thank the staff of Biotechnology R&D Center, National Taiwan University Hospital, Hsin-Chu Branch for their assistance in statistical analysis and interpretation of results.
This study was funded by National Taiwan University Hospital, Hsinchu Branch (Grant Numbers HCH104-10 and HCH105-7) and by the Ministry of Science and Technology (Grant Number 106-2314-B-002-173-MY3). The funders had no role in the study design, in the collection, analysis or interpretation of data, in writing this report, or in the decision to submit this report for publication.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.National Kidney Foundation. Dialysis outcomes quality initiative: NKF-DOQI clinical practice guidelines for vascular access. Am J Kidney Dis. 1997;30(4 Suppl 3):S150–91.Google Scholar