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Thrombolysis for acute upper extremity deep vein thrombosis
Joshua Feinberg1, Emil Eik Nielsen, Janus C Jakobsen
1Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, Denmark, 2100.
The Cochrane Database of Systematic Reviews
|December 12, 2017
Summary
Thrombolysis for upper extremity deep vein thrombosis lacks sufficient evidence. No trials were found, highlighting the need for large, unbiased clinical studies to determine its benefits and harms.
Area of Science:
- Vascular Medicine
- Thrombosis Research
- Systematic Review Methodology
Background:
- Deep vein thrombosis (DVT) in upper extremities accounts for 5-10% of all DVTs.
- Potential serious complications include post-thrombotic syndrome and pulmonary embolism.
- Thrombolysis is a theoretical treatment to avoid these complications, but its efficacy for upper extremity DVT is unassessed.
Purpose of the Study:
- To systematically review the evidence on the beneficial and harmful effects of thrombolysis for acute upper extremity deep vein thrombosis.
Main Methods:
- Comprehensive search of multiple databases and trial registries (Cochrane CIS, CENTRAL, WHO ICTRP, ClinicalTrials.gov, ISRCTN, EMA, FDA).
- Inclusion of randomized clinical trials regardless of publication status or language.
- Planned assessment of risk of bias, trial sequential analysis, and GRADE approach for evidence quality.
Main Results:
- No eligible randomized clinical trials were identified for inclusion.
- No ongoing trials investigating thrombolysis for upper extremity deep vein thrombosis were found.
Conclusions:
- Insufficient evidence exists to conclude on the benefits or harms of thrombolysis for acute upper extremity deep vein thrombosis.
- Large, low-risk-of-bias randomized clinical trials focusing on clinical outcomes are warranted.
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