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Updated: May 3, 2026

Prehospital Thrombolysis: A Manual from Berlin
05:52

Prehospital Thrombolysis: A Manual from Berlin

Published on: November 26, 2013

25.1K

Basic data related to thrombolytic therapy for acute venous thrombosis

Tina T Ng1, Michael Sigman1, Fred A Weaver1

  • 1Division of Vascular Surgery and Endovascular Therapy, USC Cardiovascular Thoracic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA.

Annals of Vascular Surgery
|January 21, 2014
PubMed

Insights

Current treatment guidelines for iliofemoral deep venous thrombosis (DVT) lack robust data. This review summarizes existing evidence on catheter-directed thrombolysis (CDT) and pharmacomechanical thrombectomy to inform future DVT management strategies.

Area of Science:

  • Vascular Medicine
  • Interventional Cardiology
  • Thrombosis Research

Background:

  • Treatment guidelines for iliofemoral deep venous thrombosis (DVT) are based on limited observational and prospective studies.
  • The ATTRACT trial is the first large, multicenter randomized control trial for iliofemoral DVT treatment strategies.
  • Existing data on catheter-directed thrombolysis (CDT) and pharmacomechanical thrombectomy for acute iliofemoral DVT are limited.

Purpose of the Study:

  • To summarize existing data informing the use of catheter-directed thrombolysis (CDT) or pharmacomechanical thrombectomy.
  • To provide a foundation for understanding current treatment strategies in acute iliofemoral DVT.
  • To contextualize the upcoming results from the ATTRACT trial.

Main Methods:

  • A comprehensive literature search was conducted using PubMed, Ovid, and Cochrane databases.
  • Searched for articles published up to December 2013.
  • Included studies with at least 25 patients, case series, national registry data, and randomized control trials.

Main Results:

  • Nineteen case series (1996-2012) and three national registry studies were identified.
  • Treatment modalities included anticoagulation, surgical thrombectomy, pharmacomechanical thrombectomy, and CDT.
  • Only two randomized control trials (2002-2012) were found, both supporting CDT over anticoagulation alone for iliofemoral DVT.

Conclusions:

  • Current treatment guidelines for acute iliofemoral DVT are based on limited clinical data.
  • The evidence base for CDT and pharmacomechanical thrombectomy in iliofemoral DVT requires further robust investigation.
  • This summary anticipates the findings of the ongoing ATTRACT trial to refine DVT treatment guidelines.
Abstract

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