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Thrombophilia Associated with Early Post-angioplasty Thrombosis of Dialysis Vascular Access

  • Clinical Investigation
  • Venous Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Aim

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.

Results

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).

Conclusion

Thrombophilia is associated with early occlusion after angioplasty for hemodialysis vascular access.

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Acknowledgements

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.

Funding

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.

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Authors and Affiliations

  1. Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Jingo Road, Section 1 Lane 442, No. 25, Hsinchu City, Taiwan

    Tsung-Yan Chen, Lin Lin, Mu-Yang Hsieh & Chih-Cheng Wu

  2. College of Medicine, National Taiwan University, Taipei, Taiwan

    Mu-Yang Hsieh & Chih-Cheng Wu

  3. Hemodialysis Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan

    Chiu-Hui Chen

  4. Department of Family Medicine, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan

    Meng-Kan Chen

  5. Institute of Biomedical Engineering, National Tsing-Hua University, Hsinchu, Taiwan

    Chih-Cheng Wu

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  1. Tsung-Yan Chen
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  2. Lin Lin
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Correspondence to Chih-Cheng Wu.

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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.

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Informed consent was obtained from all individual participants included in the study.

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Chen, TY., Lin, L., Hsieh, MY. et al. Thrombophilia Associated with Early Post-angioplasty Thrombosis of Dialysis Vascular Access. Cardiovasc Intervent Radiol 41, 1683–1690 (2018). https://doi.org/10.1007/s00270-018-2046-5

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  • DOI: https://doi.org/10.1007/s00270-018-2046-5

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