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A systematic review of paediatric deep venous thrombolysis

Mohamed Ah Taha1,2, Andrew Busuttil1, Roshan Bootun1

  • 11 Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, UK.

Phlebology
|June 5, 2018
PubMed

Insights

Catheter-directed thrombolysis effectively treats pediatric deep vein thrombosis (DVT) with a low complication rate. This therapy reduces the risk of post-thrombotic syndrome and DVT recurrence in children.

Area of Science:

  • Pediatric Thrombosis and Hemostasis
  • Vascular Medicine
  • Interventional Cardiology

Background:

  • Deep venous thrombosis (DVT) in children presents unique challenges.
  • Effective and safe treatment options are crucial for long-term outcomes.
  • Catheter-directed thrombolysis is an emerging therapeutic strategy.

Purpose of the Study:

  • To evaluate the efficacy and safety of catheter-directed thrombolysis in pediatric DVT.
  • To assess the long-term effects of this intervention.
  • To compare outcomes with other treatment modalities.

Main Methods:

  • Systematic review and meta-analysis of cohort studies.
  • Searched EMBASE, Medline, and Cochrane databases for pediatric DVT thrombolysis studies.
  • Included seven cohort studies with 183 patients.

Main Results:

  • Technical success rate of 82%, with regional thrombolysis showing superior outcomes (p < 0.00001).
  • Low complication rates: major bleeding (2.8%), pulmonary embolism (1.8%).
  • Post-thrombotic syndrome rate of 12.7% and re-thrombosis incidence of 12.3%–27%.

Conclusions:

  • Catheter-directed thrombolysis is an effective and safe treatment for pediatric DVT.
  • This approach can decrease the incidence of post-thrombotic syndrome and DVT recurrence.
  • Further research may optimize treatment protocols and long-term management.
Abstract

Keywords:
Thrombolysischildrendeep venous thrombosispaediatricpost-thrombotic syndromesystematic review

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