A Retrospective Comparison of Ultrasound-Assisted Catheter-Directed Thrombolysis and Catheter-Directed Thrombolysis Alone for Treatment of Proximal Deep Vein Thrombosis

Journal Article · Mon Aug 15 04:00:00 EDT 2016 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-016-1367-5· OSTI ID:22645473

Brodin, Ellen E.; Vik, Anders; Isaksen, Trond ^[1]; Skjeldestad, Finn Egil ^[2]; Kumar, Satish; Trasti, Nora C.; Singh, Kulbir ^[3]; Hansen, John-Bjarne ^[1]

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1. UiT – The Arctic University of Norway, K. G. Jebsen – Thrombosis Research and Expertise Centre (TREC), Department of Clinical Medicine (Norway)
2. UiT – The Arctic University of Norway, Research Group Epidemiology of Chronic Diseases, Department of Community Medicine (Norway)
3. University Hospital of North Norway, Department of Radiology (Norway)

BackgroundRecent studies have suggested that catheter-directed thrombolysis (CDT) reduces development of post-thrombotic syndrome (PTS). Ultrasound-assisted CDT (USCDT) might enhance the efficiency of thrombolysis. We aimed to compare USCDT with CDT on efficacy, safety, development of PTS, and quality of life after long-term follow-up.MethodsWe describe a retrospective case series of 94 consecutive patients admitted with iliofemoral or more proximal deep vein thrombosis (DVT) to the University Hospital from 2002 to 2011, treated either with CDT or USCDT. Scheduled follow-up visits took place between April 2013 and January 2014. Venography measured the degree of residual luminal obstruction of the affected veins. Each patient completed the Short Form 36-item health survey assessment and the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms questionnaires. PTS was assessed using the Villalta scale.ResultsRisk factors of DVT were equally distributed between groups. In the USCDT group, we observed a significant decline in the duration of thrombolytic treatment (<48 h: 27 vs. 10 %), shortened hospital stay (median 6.0 days (IQR 5.0–9.0) vs. 8.0 (IQR 5.8–12.0)), and less implantation of (intravenous) stents (30 vs. 55 %). There was no difference in patency (76 vs. 79 % fully patent), prevalence of PTS (52 vs. 55 %), or quality of life between groups after long-term follow-up (median 65 months, range: 15–141).ConclusionsIn this observational study, USCDT was associated with shortened treatment duration, shorter hospital stay, and less intravenous stenting, compared to CDT alone without affecting the long-term prevalence of PTS or quality of life.

• OSTI ID: 22645473
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 8 Vol. 39; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
HOSPITALS
PATIENTS
PHENOBARBITAL
THROMBOSIS
VEINS