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An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug
Published on: June 4, 2021
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Thrombolysis for acute deep vein thrombosis
Lorna Watson1, Cathryn Broderick, Matthew P Armon
1Cameron House, Cameron Bridge, Windygates, Leven, UK, KY8 5RG.
The Cochrane Database of Systematic Reviews
|November 11, 2016
Summary
Thrombolysis significantly reduces long-term post-thrombotic syndrome (PTS) complications in deep vein thrombosis (DVT) patients. While increasing bleeding risk, it improves venous patency and reduces PTS incidence by one-third.
Area of Science:
- Vascular Medicine
- Interventional Cardiology
Background:
- Standard deep vein thrombosis (DVT) treatment focuses on immediate complication reduction.
- Thrombolysis, or clot-dissolving drugs, may mitigate long-term post-thrombotic syndrome (PTS) complications like pain, swelling, and skin discoloration.
Purpose of the Study:
- To evaluate the efficacy of thrombolytic therapy combined with anticoagulation versus anticoagulation alone for acute lower limb DVT.
- To assess impacts on pulmonary embolism, recurrent DVT, bleeding, PTS, and venous patency.
Main Methods:
- Systematic review and meta-analysis of 17 randomized controlled trials (RCTs) involving 1103 participants.
- Included systemic, loco-regional, and catheter-directed thrombolysis (CDT) methods.
- Assessed study quality using Cochrane risk of bias tool and GRADE criteria.
Main Results:
- Thrombolysis significantly increased complete clot lysis and venous patency.
- Reduced PTS incidence by approximately one-third up to five years post-treatment (moderate quality evidence).
- Associated with increased bleeding complications (moderate quality evidence); no significant effect on mortality or conclusive data on PE/recurrent DVT.
Conclusions:
- Thrombolysis improves venous patency and significantly reduces PTS following proximal DVT.
- Systemic thrombolysis and CDT demonstrate similar effectiveness.
- Strict eligibility criteria may enhance safety by reducing bleeding risks, potentially limiting treatment applicability.
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