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논문분류	춘계학술대회 초록집
제목	Pharmacomechanical Thrombectomy versus Catheter-Directed Thrombolysis for Thrombosed Arteriovenous Dialysis Access: A TriNetX-database Analysis
저자	Sajjad Ahmed Khan
출판정보	2026; 2026(1):
키워드	Pharmacomechanical Thrombectomy, Catheter-Directed Thrombolysis, Thrombosed Arteriovenous Dialysis Access, Outcomes
초록	Objectives: To compare the outcomes of pharmaceutical thrombectomy versus catheter directed thrombolysis among chronic kidney disease (CKD) patients dependent on renal dialysis with thrombosed hemodialysis vascular access; in terms of rethrombosis, GI hemorrhage, inpatient encounter, sepsis and all cause mortality following dialysis. Methods: Adult patients (≥18 years) with diagnosed cases of CKD stage 5 or End-stage renal disease (ESRD) dependent dialysis with thrombosed hemodialysis vascular access were divided into two groups: those undergoing pharmacomechanical thrombectomy versus catheter-directed thrombolysis. Study was conducted in the TriNetX database and propensity matching was done to eliminate potential biases. Risk ratio, cumulative incidence, hazard ratios were estimated and a p < 0.05, was considered statistically significant. Results: Each cohort was accessed for outcomes following propensity matching to eliminate selection bias. Re-thrombosis occurred more frequently following thrombectomy than thrombolysis (59.7% vs 49.6%; RR 1.21, 95% CI 1.15–1.26; p<0.001), with a higher hazard of re-thrombosis (HR 1.20, 95% CI 1.13–1.28; p<0.001). The risk of gastrointestinal hemorrhage was similar between groups (13.5% vs 13.4%; RR 1.01, 95% CI 0.90–1.14; p=0.834), with no clinically meaningful difference in hazard (HR 0.92, 95% CI 0.81–1.04; p=0.027). Thrombectomy was associated with a lower risk of sepsis compared with thrombolysis (34.6% vs 39.2%; RR 0.88, 95% CI 0.83–0.94; p<0.001) and a significantly reduced hazard of sepsis (HR 0.76, 95% CI 0.71–0.83; p<0.001). Inpatient encounters were less frequent in the thrombectomy group (73.7% vs 77.3%; RR 0.95, 95% CI 0.93–0.98; p<0.001), with a lower hazard of hospitalization (HR 0.73, 95% CI 0.69–0.77; p<0.001). All-cause mortality was significantly reduced following thrombectomy (34.8% vs 42.1%; RR 0.83, 95% CI 0.78–0.88; p<0.001), with improved overall survival (HR 0.73, 95% CI 0.68–0.79; p<0.001). Conclusion: Compared to the thrombolytic group, pharmacomechanical thrombectomy was associated with higher rates of re-thrombosis but lower risk of complications.
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