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Impact of COVID-19 pandemic on hemodialysis access thrombosis

Min S Cho1, Zain Javed1, Ravi Patel1

  • 1Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.

The Journal of Vascular Access
|August 12, 2022
PubMed

Insights

The COVID-19 pandemic saw an increase in hemodialysis access thromboses and thrombectomy procedures, particularly for arteriovenous fistulas. This suggests delayed care may impact access function.

Area of Science:

  • Vascular Surgery
  • Nephrology
  • Interventional Radiology

Background:

  • Delayed care for stenosis or thrombosis risks losing functioning hemodialysis access.
  • The COVID-19 pandemic restricted access to care and resources.
  • Assessing the pandemic's impact on arteriovenous fistula (AVF) and arteriovenous graft (AVG) procedures is crucial.

Purpose of the Study:

  • To evaluate the impact of the COVID-19 pandemic on AVF and AVG procedures.
  • To compare the number and success rates of thrombectomies before and during the pandemic.

Main Methods:

  • Examined AVF and AVG angiograms (with and without interventions) from April 2017-March 2021.
  • Compared data from the pre-COVID-19 era (April 2017-March 2020) and the COVID-19 era (April 2020-March 2021).

Main Results:

  • Thrombectomies constituted a higher proportion of procedures during the COVID-19 era (13.3% vs 8.7%).
  • This increase was significant for AVFs (8.2% vs 3.0%) but not for AVGs (26.5% vs 27%).
  • A trend towards higher rates of unsuccessful thrombectomies was observed during the pandemic (33.3% vs 20.4%).

Conclusions:

  • Hemodialysis access thromboses and unsuccessful thrombectomies increased during the COVID-19 pandemic.
  • Delayed patient procedures to maintain dialysis access may explain these findings.
Abstract

Keywords:
COVID-19arteriovenous fistulaarteriovenous graftdialysis accessinterventional nephrologythrombectomythrombosis

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