Thrombolysis for XXXX in hemodialysis: international survey of expert opinion.

@entity1 @entity64 @entity385
BACKGROUND AND OBJECTIVES: Although data are absent, it has been stated that thrombolysis is probably not safe in the treatment of @entity64 in @entity1 undergoing hemodialysis. The objective of this study was for @entity64 experts to define the range of management concerning thrombolytic treatment of @entity64 in hemodialysis. DESIGN, SETTING, @entity1 , _ MEASUREMENTS: Sixty-five @entity64 experts in thrombolytic therapy of acute @entity385 were queried regarding their personal experience in the use of thrombolysis in hemodialysis @entity1 . Hypothetical case scenarios were presented. RESULTS: Of the 65 @entity64 experts who were queried, 40 (62%) responded. One-third of the responders had previously treated hemodialysis @entity1 with recombinant tissue-type plasminogen activator (rt-PA). Most favored use of intravenous rt-PA for hemodialysis @entity1 with acute @entity385 . When presented with a case of a @entity1 who had recently undergone dialysis with a mildly prolonged activated partial thromboplastin time (aPTT), 50% favored immediate intravenous thrombolysis. Seventy-eight percent of the experts would have considered an intra-arterial approach and would have preferred mechanical clot retrieval to thrombolysis. CONCLUSIONS: Despite the acknowledged absence of data and prevalent concerns about bleeding risk, most surveyed experts favored its use. One-third reported treating hemodialysis @entity1 with this therapy. Although these results do not substitute for data, they usefully define the range of current practice of @entity64 experts.
