Catheter-directed thrombolysis in the treatment of acute deep venous thrombosis: a meta-analysis

Zheng, Jie; Zhang, Z.H.; Zhang, Shan; Wang, W.J.; Li, X.X.; Wang, S.M.; Li, Y.-X.; Cheng, Gesheng

doi:10.4238/2014.july.24.1

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…We identified 3 systematic reviews 119,212,213 and 5 controlled trials (n 5 427). 142,[214][215][216][217] Trials included individuals with objectively confirmed symptomatic proximal DVT.…”

Section: Summary Of the Evidencementioning

confidence: 99%

American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism

Ortel

Neumann

Ageno³

et al. 2020

Blood Advances

871

708

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Background: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), occurs in ∼1 to 2 individuals per 1000 each year, corresponding to ∼300 000 to 600 000 events in the United States annually. Objective: These evidence-based guidelines from the American Society of Hematology (ASH) intend to support patients, clinicians, and others in decisions about treatment of VTE. Methods: ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and adult patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment. Results: The panel agreed on 28 recommendations for the initial management of VTE, primary treatment, secondary prevention, and treatment of recurrent VTE events. Conclusions: Strong recommendations include the use of thrombolytic therapy for patients with PE and hemodynamic compromise, use of an international normalized ratio (INR) range of 2.0 to 3.0 over a lower INR range for patients with VTE who use a vitamin K antagonist (VKA) for secondary prevention, and use of indefinite anticoagulation for patients with recurrent unprovoked VTE. Conditional recommendations include the preference for home treatment over hospital-based treatment for uncomplicated DVT and PE at low risk for complications and a preference for direct oral anticoagulants over VKA for primary treatment of VTE.

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“…We identified 3 systematic reviews 119,212,213 and 5 controlled trials (n 5 427). 142,[214][215][216][217] Trials included individuals with objectively confirmed symptomatic proximal DVT.…”

Section: Summary Of the Evidencementioning

confidence: 99%

American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism

Ortel

Neumann

Ageno³

et al. 2020

Blood Advances

871

708

View full text Add to dashboard Cite

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“…The pooled results of five involved comparison studies strengthen the conclusion that the CDT group has a significantly higher patency rate than the anticoagulation group. A previous meta-analysis 48 pooling eight RCTs in China suggested that the effective rate of CDT for the treatment of acute lower extremity DVT was significantly higher than that for superficial venous thrombolysis. The reason was thought to be that thrombolytic drugs can directly act on the thrombolysis site to maximize the activation of plasminogen and effectively dissolve the thrombus.…”

Section: Discussionmentioning

confidence: 99%

Catheter-directed thrombolysis for patients with acute lower extremity deep vein thrombosis: a meta-analysis

Zhang

et al. 2018

Rev. Latino-Am. Enfermagem

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Objectives: To evaluate case series studies that quantitatively assess the effects of catheter-directed thrombolysis (CDT) and compare the efficacy of CDT and anticoagulation in patients with acute lower extremity deep vein thrombosis (DVT). Methods: Relevant databases, including PubMed, Embase, Cochrane, Ovid MEDLINE and Scopus, were searched through January 2017. The inclusion criteria were applied to select patients with acute lower extremity DVT treated with CDT or with anticoagulation. In the case series studies, the pooled estimates of efficacy outcomes for patency rate, complete lysis, rethrombosis and post-thrombotic syndrome (PTS) were calculated across the studies. In studies comparing CDT with anticoagulation, summary odds ratios (ORs) were calculated. Results: Twenty-five articles (six comparing CDT with anticoagulation and 19 case series) including 2254 patients met the eligibility criteria. In the case series studies, the pooled results were a patency rate of 0.87 (95% CI: 0.85-0.89), complete lysis 0.58 (95% CI: 0.40-0.75), rethrombosis 0.11 (95% CI: 0.06-0.17) and PTS 0.10 (95% CI: 0.08-0.12). Six studies comparing the efficacy outcomes of CDT and anticoagulation showed that CDT was associated with a reduction of PTS (OR 0.38, 95%CI 0.26-0.55, p<0.0001) and a higher patency rate (OR 4.76, 95%CI 2.14-10.56, p<0.0001). Conclusion: Acute lower extremity DVT patients receiving CDT were found to have a lower incidence of PTS and a higher incidence of patency rate. In our meta-analysis, CDT is shown to be an effective treatment for acute lower extremity DVT patients.

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Catheter-directed thrombolysis in the treatment of acute deep venous thrombosis: a meta-analysis

Cited by 2 publications

References 17 publications

American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism

American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism

Catheter-directed thrombolysis for patients with acute lower extremity deep vein thrombosis: a meta-analysis

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