ASH: Catheter-Directed Thrombolysis Cuts DVT Risks
CDT lowers post-thrombotic syndrome frequency, ups iliofemoral patency in deep vein thrombosis
TUESDAY, Dec. 13 (HealthDay News) -- For patients with deep vein thrombosis (DVT), additional catheter-directed thrombolysis (CDT) reduces the frequency of post-thrombotic syndrome (PTS) and improves iliofemoral patency, according to a study published online Dec. 13 in The Lancet to coincide with presentation at the annual meeting of the American Society of Hematology, held from Dec. 10 to 13 in San Diego.
Tone Enden, M.D., from the University of Oslo in Norway, and colleagues investigated whether additional treatment with CDT reduced development of PTS. A total of 209 patients, aged 18 to 75 years, with first-time iliofemoral DVT were selected within 21 days from symptom onset. Participants were randomly assigned to conventional treatment alone (108 patients) or additional CDT (101 patients). Co-primary outcomes were the frequency of PTS, as measured by Villalta score at 24 months, and iliofemoral patency after six months, which were assessed by intention-to-treat analysis.
The investigators found that clinical status data were available for 90 percent of patients after completion of 24 months of follow-up. PTS was identified in 41.1 percent of patients given additional CDT, compared with 55.6 percent of patients in the control group at 24 months (P = 0.047), corresponding to an absolute risk reduction of 14.4 percent. Iliofemoral patency after six months was reported in significantly more patients in the CDT group versus controls (65.9 versus 47.4 percent). Three major and five clinically relevant bleeds were identified among 20 bleeding complications related to CDT.
"Additional CDT should be considered in patients with a high proximal DVT and low risk of bleeding," the authors write.