Abstract: SA-PO0470
Pulmonary Embolism from Arteriovenous Fistula Thrombosis Requiring Intubation
Session Information
- Dialysis: Vascular Access
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Yoshinaga, Kai, Wright State University Boonshoft School of Medicine, Dayton, Ohio, United States
- Stauder, Connor, Wright State University Boonshoft School of Medicine, Dayton, Ohio, United States
- Lovekar, Shachi S., Wright State University Boonshoft School of Medicine, Dayton, Ohio, United States
Introduction
Arteriovenous fistula (AVF) or graft thrombosis is a known complication of the creation and maintenance of the fistulas used for hemodialysis. Pulmonary emboli are an uncommon complication of percutaneous thrombolysis procedures done to address this, and those that ensue are usually asymptomatic. We present the case of a relatively healthy male who underwent fistulogram for clotted arteriovenous fistula and developed massive pulmonary emboli.
Case Description
A 50 year old male with past medical history of hypertension and end stage renal disease, but no prior history of hypercoagulable state, presented for an outpatient percutaneous thrombectomy of a clotted AVF. He developed severe hypoxemic respiratory failure and shock during the procedure requiring endotracheal intubation and vasopressors. Computed tomography (CT) of his chest demonstrated large multifocal pulmonary emboli of the right upper lobar pulmonary artery and two right lower segmental arteries.
He was transferred to the ICU and anticoagulated with heparin. Ventilatory support was weaned and he was extubated successfully within 48 hours. He was discharged 13 days later on oral anticoagulation.
Discussion
Percutaneous thrombectomy is a common procedure to treat AV access thrombosis in hemodialysis patients. While routine, significant compliations and subsequent morbidity can arise due to this procedure. Our case highlights the need to be aware of these complications in order to expediently address and correct them to avoid long-term morbidity or mortality.
Figure 1: CT scan demonstrating a right upper lobe pulmonary embolism
Figure 2: Ultrasound demonstrating AVF thrombus formation.