Monitoring of haemostatic parameters during thrombolysis with rtPA for deep venous thrombosis: correlation with clinical events

Grünewald, Martin; Grießhammer, Martin; Ellbrück, D.; Seifried, Erhard

doi:10.1054/fipr.2000.0093

Cited by 1 publication

(4 citation statements)

References 24 publications

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“…Grünewald et al [ 9 ] discussed the correlation between clinical events and hemostatic parameters during systemic thrombolysis in lower limb DVT and shows that persistent high level or plateau of DD and fibrinogen degradation products (FDPS) during thrombolysis indicate either;…”

Section: Resultsmentioning

confidence: 99%

“…Grünewald et al [ 9 ] found that there is no relationship between fibrinogen level and bleeding incidence or treatment success (P=0.06).…”

Section: Resultsmentioning

confidence: 99%

“…Grünewald et al [ 9 ] observed that during continuous systemic tPA infusion there was significant decrease of PAI-1 from day 3 to day 5 and PAI-1 level was significantly lower in patients with bleeding comparing to those without (P=0.01), suggesting that serial measurements of PAI-1 might help to predict bleeding and prevent it (level 2 evidence).…”

Section: Resultsmentioning

confidence: 99%

“…Grünewald et al [ 9 ] representing the only RCT on patients undergoing thrombolytic therapy for deep venous thrombosis that correlate between hemostatic parameters and clinical event such as therapeutic outcome and bleeding complications.…”

Section: Methodsmentioning

confidence: 99%

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Safety and Efficacy of Catheter Direct Thrombolysis in Management of Acute Iliofemoral Deep Vein Thrombosis: A Systematic Review

Elbasty

Metcalf

2017

VSI

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PurposeCatheter direct thrombolysis (CDT) has been shown to be an effective treatment for deep venous thrombosis. The objective of the review is to improve safety and efficacy of the CDT by using ward based protocol, better able to predict complications and treatment outcome through monitoring of haemostatic parameters and clinical observation during thrombolysis procedure.Materials and MethodsMEDLINE, EMBASE, CENTRAL and Web of Science were searched for all articles on deep venous thrombosis, thrombolysis and correlations of clinical events (bleeding, successful thrombolysis) during thrombolysis with hemostatic parameters to March 2016. The risk of bias in included studies was assessed by Cochrane Collaboration’s tool and Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions.ResultsTwenty-four studies were included in the review and we found that improving safety and efficacy of CDT by using ward based protocol depending on eight factors; strict patient selection criteria, types of fibrinolytic drugs, mode of fibrinolytic drug injection, biochemical markers monitoring (fibrinogen, D-dimer, activated partial thromboplastin time, plasminogen activator inhibitor-1), timing of intervention, usage of intermittent pneumatic calf, ward monitoring and thrombolysis imaging assessment (intravascular ultrasound). These factors may help to improve safety and efficacy by reducing total thrombolytic drug dosage and at the same time ensure successful lysis. There is a marked lack of randomized controlled trials discussing the safety and efficacy of catheter direct thrombolysis.ConclusionCDT can be performed safely and efficiently in clinical ward, providing that careful nursing, biochemical monitoring, proper selection and mode of infusion of fibrinolytic drugs, usage of Intermittent pneumatic calf and adequate thrombolysis imaging assessment are ensured.

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Section: Resultsmentioning

confidence: 99%

“…Grünewald et al [ 9 ] found that there is no relationship between fibrinogen level and bleeding incidence or treatment success (P=0.06).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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