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Outcomes in children with deep vein thrombosis managed with percutaneous endovascular thrombolysis

Christopher E Dandoy1, Kamlesh U Kukreja, Ralph A Gruppo

  • 1Division of Hematology, Cancer & Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 11027, Cincinnati, OH, 45229, USA.

Pediatric Radiology
|November 8, 2014
PubMed

Insights

Percutaneous endovascular thrombolysis is a safe and effective treatment for pediatric deep venous thrombosis (DVT), potentially reducing post-thrombotic syndrome. Further trials are needed to confirm long-term benefits.

Area of Science:

  • Pediatric vascular medicine
  • Interventional radiology
  • Thrombosis management

Background:

  • Limited data exists on endovascular thrombolysis safety and efficacy in children.
  • Post-thrombotic syndrome (PTS) incidence after pediatric thrombolysis is not well-established.

Purpose of the Study:

  • To evaluate the safety and efficacy of percutaneous endovascular thrombolysis in pediatric deep venous thrombosis (DVT).
  • To determine the frequency of post-thrombotic syndrome (PTS) diagnosis following thrombolysis in children.

Main Methods:

  • Retrospective analysis of pediatric patients undergoing endovascular thrombolysis for DVT (November 2008 - June 2013).
  • Review of demographic data, technical success, complications, and standardized PTS scoring.

Main Results:

  • Forty-one children (3 months - 21 years) underwent thrombolysis; 90% achieved >50% thrombus lysis.
  • Four out of 28 patients (14%) met diagnostic criteria for PTS.
  • One major bleeding and one pulmonary embolism occurred, with no long-term sequelae.

Conclusions:

  • Endovascular thrombolysis is a safe and effective pediatric DVT treatment for thrombus removal.
  • This procedure may decrease the incidence of post-thrombotic syndrome in children.
  • Larger trials are necessary to ascertain long-term benefits.
Abstract

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