Catheter-directed thrombolysis in the treatment of acute deep venous thrombosis: a meta-analysis
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Published on: June 4, 2021
J J Zheng1, Z H Zhang2, Z Shan2
1Cardiac Surgery, The First Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, Shaan Xi, China JianJieZhengcn@163.com.
Insights
Catheter thrombolysis significantly improves treatment outcomes for acute lower limb deep vein thrombosis compared to superficial venous thrombolysis. Further high-quality trials are needed to confirm these findings.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiovascular Medicine
Background:
- Acute lower limb deep vein thrombosis (DVT) is a significant vascular condition.
- Current treatment strategies require systematic evaluation for optimal patient outcomes.
- Catheter-directed thrombolysis and superficial venous thrombolysis are established interventions.
Purpose of the Study:
- To systematically evaluate the efficacy of catheter thrombolysis versus superficial venous thrombolysis for acute lower limb DVT.
- To provide a meta-analysis of available randomized controlled trials (RCTs) in the Chinese population.
Main Methods:
- A comprehensive literature search was conducted across multiple Chinese and international databases (CBM, CNKI, Weipu, Wanfang, Medline).
- Inclusion criteria focused on RCTs comparing catheter-directed thrombolysis and superficial venous thrombolysis for acute DVT.
- Meta-analysis was performed using RevMan 4.2 software, with odds ratio (OR) as the primary efficacy measure.
Main Results:
- Eight RCTs were included in the meta-analysis.
- Catheter thrombolysis demonstrated a significantly higher overall effective treatment rate compared to superficial venous thrombolysis (OR = 11.78, P < 0.01).
Conclusions:
- Catheter thrombolysis is a more effective treatment for acute lower limb DVT than superficial venous thrombolysis in the Chinese population.
- The quality of the included trials was moderate, highlighting the need for more robust and scientifically rigorous clinical studies to validate these results.
Abstract:
We performed a meta-analysis for systematic evaluation of the status quo of catheter thrombolysis for the treatment of acute lower limb deep vein thrombosis in China. We searched the China Biomedical bibliographic database (CBM), China National Knowledge Infrastructure (CNKI), Weipu full-text electronic journals, Wanfang full-text database, and Medline (1990 through June 2011) for clinical randomized controlled trials of catheter-directed thrombolysis and superficial venous thrombolysis to compare their efficacies for the treatment of acute deep vein thrombosis. The results were analyzed by using the Cochrane-recommended RevMan 4.2 software package, and the odds ratio (OR) was used as the combined measure of efficacy. The search retrieved 8 randomized controlled trials, and meta-analysis using the total rate of effective treatment as the clinical observation index found that the combined OR for the catheter thrombolysis group versus the superficial venous thrombolysis group was significant (P < 0.01; OR = 11.78; 95% confidence interval = 6.99-19.87). In conclusion, the meta-analysis indicated that catheter thrombolysis was more effective than superficial venous thrombolysis for the treatment of acute deep vein thrombosis in the lower limb in Chinese individuals. However, the included trials were only of medium quality, so more rational and scientific clinical trials are needed to validate this conclusion.
