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Catheter Directed Thrombolysis for Proximal Deep Vein Thrombosis- Cochrane Database Review

  • 02
    Apr

     

    Williamsville, NY

     

     CDT Catheter Directed Thrombolysis for Proximal Deep Vein Thrombosis has been popularized lately as a means to dissolve clots and to potentially reduce the late sequelae including post thrombotic syndrome (PTS). The signs and symptoms of post thrombotic syndrome include pain, swelling, skin discolouration, or venous ulceration in the affected leg.

     

    The authors of this study, Watson L, Broderick C and Armon MP have published their research in the Cochrane Database Syst Rev. 2016 Nov 10.  The aim of their study was to assess the effects of thrombolytic therapy (TT) and anticoagulation compared to anticoagulation alone for the management of people with acute deep vein thrombosis (DVT) of the lower limb. Randomised controlled trials (RCTs) examining thrombolysis and anticoagulation versus anticoagulation for acute DVT were analyzed for this review. 

     

    Seventeen randomized controlled trials with 1103 participants were included in this analysis. 


    The authors concluded:

     

    1) thrombolysis increases the patency of veins and reduces the incidence of post thrombotic syndrome following proximal DVT by one third.

     

    2) systemic administration and catheter directed thrombolysis have similar effectiveness.

     

    3) Strict eligibility criteria appears to improve safety in recent studies and may be necessary to reduce the risk of bleeding complications.

     

    4) In those who are treated there is a small increased risk of bleeding. 

     
     
    Dr. Karamanoukian's comments:  This is a very improtant and timely study and the fact that it is a Cochrane database review increases its importance as it is unbiased and baased on analysis from published randomized controlled trials. I have written a book about post thrombotic syndrome and my patients can access it for free on the ebook section of this website. Post thrombotic syndrome is more likely with proximal deep vein thrombosis and early thrombolysis, whether systemc or catheter directed thrombolysis (CDT) reduces the likelihood of developing the late sequelae of this condition as concluded in this study. 

    TO ACCESS my free ebook about post thrombotic syndrome go to the ebook section of my website
    veinsveinsveins.com/113/ebooks/