Related Experiment Video

Updated: Jul 27, 2025

An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug
07:50

An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug

Published on: June 4, 2021

2.8K

Catheter-Directed Thrombolysis Protocols for Deep Venous Thrombosis of the Lower Extremities-A Systematic Review and

Luís Duarte-Gamas1,2, Filipa Jácome1,2, Lara Romana Dias1,2

  • 1Department of Angiology and Vascular Surgery, São João University Hospital Center, Porto, Portugal.

Thrombosis and Haemostasis
|June 6, 2023
PubMed

Insights

Catheter-directed thrombolysis (CDT) is a low-risk treatment for lower extremity deep venous thrombosis (LE-DVT). However, varied treatment protocols make assessing outcomes like post-thrombotic syndrome difficult.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiology

Background:

  • Lower extremity deep venous thrombosis (LE-DVT) is a significant vascular condition.
  • Catheter-directed thrombolysis (CDT) is an emerging treatment option for LE-DVT.
  • Understanding the efficacy and safety of various CDT protocols is crucial.

Purpose of the Study:

  • To systematically review and summarize the characteristics, complications, and success rates of different catheter-directed thrombolysis (CDT) protocols for treating lower extremity deep venous thrombosis (LE-DVT).

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials and observational studies were conducted.
  • Electronic databases (MEDLINE, Scopus, Web of Science) were searched for relevant LE-DVT and CDT studies.
  • Pooled proportions of early complications, post-thrombotic syndrome (PTS), and venous patency were calculated using a random-effects model.

Main Results:

  • Forty-six studies encompassing 49 protocols and 3,028 participants were analyzed.
  • Iliofemoral involvement was present in 90% of LE-DVT cases.
  • Pooled complication rates included minor bleeding (8.7%), major bleeding (1.2%), pulmonary embolism (1.1%), and death (0.6%).
  • Pooled incidences of PTS and venous patency at 1 year were 17.6% and 77.5%, respectively.

Conclusions:

  • Catheter-directed thrombolysis (CDT) demonstrates a low-risk profile for treating LE-DVT.
  • Heterogeneity in CDT protocols complicates the assessment of outcomes, particularly post-thrombotic syndrome (PTS) rates.
  • Further standardization of CDT protocols may improve outcome predictability.
Abstract

More Related Videos

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis06:45

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

Published on: February 10, 2023

13.7K
A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis10:26

A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis

Published on: June 2, 2015

17.3K

Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
11
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
16
Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
15
Venous Thrombosis I: Introduction01:30

Venous Thrombosis I: Introduction

Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
14
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
15
Pulmonary Embolism III: Nursing Management01:27

Pulmonary Embolism III: Nursing Management

A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
17