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[Changes in deep venous thrombosis after thrombolytic anticoagulant therapies in acute pulmonary thromboembolism]
Yuan-hua Yang1, Zhen-guo Zhai, Feng Wang
1Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
Objective:
To analyze the treatment effect of deep venous thrombosis (DVT) in acute pulmonary thromboembolism (PTE) with thrombolytic and anticoagulant therapy.
Methods:
Post hoc analysis of data from a prospective multicenter randomized control thrombolytic and anticoagulant trial of 516 patients with acute symptomatic PTE from June 2002 to December 2004. Thrombolytic therapy was performed in patients with massive and sub-massive PTE and anticoagulant therapy was given in patients with non-massive PTE. A total of 362 patients that accepted compression ultrasonography (CUS) before and 14 days after treatment constituted this study.
Results:
The ratio of detected DVT by CUS 14 days after treatment was reduction than that before treatment (chi2=22.667, P<0.001), but 11.6% patients had new or recurrent DVT. The rates of recanalization in thrombolysis group and anticoagulant group were 56.5% and 47.8% respectively (chi2=1.435, P=0.231). The results after three months follow up showed not recovery in 30.4% DVT patients and new or recurrent DVT in 10.4% patients.
Conclusions:
The normalization rate of DVT is low during 14 days treatment, and recurrence rate is high. Thrombolysis has no better rate of recanalization than anticoagulant. The prognosis of DVT hasn't improved significantly during short term treatment.
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