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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
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Catheter-directed thrombolysis for patients with acute lower extremity deep vein thrombosis: a meta-analysis

Wang Li1, Zhang Chuanlin2, Mu Shaoyu3

  • 1MSc, RN, School of Nursing, Chongqing Medical University, Chongqing, Chongqing, China.

Revista Latino-Americana De Enfermagem
|June 28, 2018
PubMed

Insights

Catheter-directed thrombolysis (CDT) offers a more effective treatment for acute lower extremity deep vein thrombosis (DVT), leading to better outcomes. This approach significantly reduces the incidence of post-thrombotic syndrome (PTS) and improves vessel patency rates.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiology

Background:

  • Acute lower extremity deep vein thrombosis (DVT) poses significant risks, including post-thrombotic syndrome (PTS) and reduced limb function.
  • Current treatment strategies aim to prevent clot propagation, reduce acute symptoms, and minimize long-term complications.
  • Catheter-directed thrombolysis (CDT) is an emerging endovascular technique for acute DVT management.

Purpose of the Study:

  • To systematically evaluate case series on catheter-directed thrombolysis (CDT) for acute lower extremity deep vein thrombosis (DVT).
  • To compare the efficacy of CDT versus anticoagulation in managing acute lower extremity DVT.
  • To assess key outcomes including patency rates, complete lysis, rethrombosis, and PTS incidence.

Main Methods:

  • A comprehensive literature search was conducted across major databases (PubMed, Embase, Cochrane, Ovid MEDLINE, Scopus) up to January 2017.
  • Inclusion criteria focused on acute lower extremity DVT patients treated with CDT or anticoagulation.
  • Pooled estimates for efficacy outcomes and odds ratios for comparative studies were calculated using meta-analysis techniques.

Main Results:

  • Analysis of 25 articles (2254 patients) revealed pooled outcomes for CDT: patency rate 0.87, complete lysis 0.58, rethrombosis 0.11, and PTS 0.10.
  • Comparative studies (6 articles) demonstrated CDT significantly reduced PTS (OR 0.38) and increased patency rates (OR 4.76) compared to anticoagulation.
  • These findings indicate a statistically significant benefit of CDT in managing acute DVT.

Conclusions:

  • Catheter-directed thrombolysis (CDT) is an effective treatment for acute lower extremity DVT.
  • CDT is associated with a lower incidence of post-thrombotic syndrome (PTS) and higher patency rates compared to anticoagulation.
  • These results support the consideration of CDT as a primary treatment modality for selected patients with acute lower extremity DVT.
Abstract

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