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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Catheter-related atrial thrombus (CRAT) is a life-threatening complication in haemodialysis (HD) patients. While management for small (<2 cm) or large (>5 cm) thrombi is loosely defined, a therapeutic void exists for intermediate-sized thrombi (2-5 cm), posing a significant clinical dilemma between high-risk surgery and unproven medical therapy. We investigated the efficacy and safety of dose-adjusted Apixaban, a direct oral anticoagulant (DOAC), for this specific indication.
We conducted a retrospective case series of all consecutive HD patients treated at our center between July 2023 and April 2025 for an intermediate-sized (2-5 cm) CRAT. All patients were given the option of surgical management vs medical manageent with DOACs. All patients opted for DOACs. They were treated with Apixaban 2.5 mg twice daily and closely followed up with weekly transthoracic echocardiograms (TTE). Transesophageal echocardiogram (TEE) was done only when clot was not visible on TTE. Data on patient demographics, thrombus characteristics, time to resolution, catheter outcomes, and complications (bleeding or thromboembolism) were collected from electronic health records. The primary outcomes were complete thrombus resolution (as ascertained by transoesophageal echocardiogram) and the incidence of major or clinically relevant non-major bleeding.
Eight patients (6 male, median age 38 years) with CRAT were included. The median baseline thrombus size was 3.3 x 4.2 cm. Complete thrombus resolution was achieved in all eight patients (100%). The median time to resolution, as confirmed by TEE, was 9 weeks. Apixaban was continued for 4 weeks after the documentation of clot resolution. There were zero (0%) bleeding or thromboembolic complications during treatment. In 5 of 8 patients (80%), therapy served as a successful bridge, allowing for safe catheter removal and transition to definitive access (2 kidney transplants, 3 AV fistulas). In three patients (37.5%), the catheter was salvaged.
In this case series, a conservative strategy with dose-adjusted Apixaban was associated with 100% thrombus resolution and an excellent safety profile for intermediate-sized CRAT in HD patients. This approach may represent a viable, non-invasive alternative to high-risk surgery, warranting further investigation in larger, prospective studies
