scholarly journals Comparison of Pharmacomechanical Catheter-Directed Thrombolysis versus Catheter-Directed Thrombolysis for the Treatment of Acute Iliofemoral Deep Vein Thrombosis: Measures of Long-Term Clinical Outcome and Quality of Life

2022 ◽  
Vol 10 (1) ◽  
pp. 283
Author(s):  
T. Huang ◽  
W. Ding ◽  
Z. Chen ◽  
Y. Yin ◽  
J. Yu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Deep Vein Thrombosis ◽  
Clinical Outcome ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Deep Vein

scholarly journals Treatment of Acute Iliofemoral Deep Vein Thrombosis; Does Catheter Directed Thrombolytic Therapy Change Outcomes?

2019 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Quality Of Life ◽  
Deep Vein Thrombosis ◽  
Iliac Vein ◽  
P Value ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Group A ◽  
Deep Vein

Background: Iliofemoral deep vein thrombosis (DVT) is associated with severe post-thrombotic morbidity when treated with anticoagulation alone. Catheter- directed thrombolysis (CDT) allows early removal of thrombus and reduces valvular reflux and Post-thrombotic Syndrome (PTS). Patients and methods: This prospective randomized multi-center controlled two- arm blind study was conducted in 6 centers on 252 patients with iliofemoral DVT. Patients were randomly allocated by using simple random allocation cards method into two groups; Group (A): CDT followed by oral anticoagulation (N=126 (50%)), Group (B): Standard DVT therapy (N=126 (50%)). Follow-up was for 24 months. Results: Patients of group (A) significantly complained less pain at 10 & 30 days (P-Value: 0.02 & 0.04 respectively). Also there was significant decrease in leg circumference in group (A) at 10 & 30 days (P-Value: 0.001 & 0.03 respectively). Patency of iliac vein segment was significantly higher in group (A) during the 24 months follow up (P-Value <0.001 (HS)). Patients in group (A) developed less PTS at six months, at one year and at two years (P-Value: 0.024, 0.017 and 0.035 respectively). Better Quality of life was observed in group (A) (P-Value: 0.003). Conclusion: Addition of catheter-directed thrombolysis in the treatment of acute iliofemoral DVT; was safe and tolerated by most of the patients with better effect to reduce leg pain & circumference. It was considered a protecting weapon to prevent post-thrombotic syndrome and so improve quality of life and was related to achievement of higher iliac vein patency and less reflux.

scholarly journals Pharmacomechanical Catheter-Directed Thrombolysis in Acute Femoral–Popliteal Deep Vein Thrombosis: Analysis from a Stratified Randomized Trial

2019 ◽  
Vol 119 (04) ◽  
pp. 633-644 ◽  
Author(s):  
Clive Kearon ◽  
Chu-Shu Gu ◽  
Jim Julian ◽  
Samuel Goldhaber ◽  
Anthony Comerota ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Femoral Vein ◽  
Leg Pain ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Recurrent Venous Thromboembolism ◽  
Thrombus Removal ◽  
Deep Vein

Background and Objectives The Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) trial reported that pharmacomechanical catheter-directed thrombolysis (PCDT) did not reduce post-thrombotic syndrome (PTS), but reduced moderate-to-severe PTS and the severity of PTS symptoms. In this analysis, we examine the effect of PCDT in patients with femoral–popliteal deep vein thrombosis (DVT) (without involvement of more proximal veins). Patients and Methods Within the ATTRACT trial, 300 patients had DVT involving the femoral vein without involvement of the common femoral or iliac veins and were randomized to receive PCDT with anticoagulation or anticoagulation alone (no PCDT). Patients were followed for 24 months. Results From 6 to 24 months, between the PCDT versus no PCDT arms, there was: no difference in any PTS (Villalta scale ≥ 5: risk ratio [RR] = 0.97; 95% confidence interval [CI], 0.75–1.24); moderate-or-severe PTS (Villalta scale ≥ 10: RR = 0.93; 95% CI, 0.57–1.52); severity of PTS scores; or general or disease-specific quality of life (p > 0.5 for all comparisons). From baseline to both 10 and 30 days, there was no difference in improvement of leg pain or swelling between treatment arms. From baseline to 10 days, major bleeding occurred in three versus none (p = 0.06) and any bleeding occurred in eight versus two (p = 0.032) PCDT versus no PCDT patients. Over 24 months, recurrent venous thromboembolism occurred in 16 PCDT and 12 no PCDT patients (p = 0.24). Conclusion In patients with femoral–popliteal DVT, PCDT did not improve short- or long-term efficacy outcomes, but it increased bleeding. Therefore, PCDT should not be used as initial treatment of femoral–popliteal DVT. (NCT00790335).

scholarly journals Quality of Life in Patients With Cancer Under Prolonged Anticoagulation for High-Risk Deep Vein Thrombosis: a Long-Term Follow-Up

2020 ◽  
Vol 26 ◽  
pp. 107602962091829 ◽  
Author(s):  
Mariasanta Napolitano ◽  
Maria Francesca Mansueto ◽  
Simona Raso ◽  
Sergio Siragusa
Keyword(s):  
Quality Of Life ◽  
Deep Vein Thrombosis ◽  
Anticoagulant Treatment ◽  
Vein Thrombosis ◽  
Patients With Cancer ◽  
Long Term Follow Up ◽  
Deep Vein

Current guidelines recommend to prolong anticoagulant treatment in patients with cancer with venous thromboembolism (VTE); only few studies evaluated other parameters than cancer itself for selecting patients at higher risk of recurrent VTE. Long-term management of VTE is thus challenged by several controversies mainly for patients compliance. We here report results of a long-term follow-up in patients with deep vein thrombosis under anticoagulant treatment with low-molecular-weight heparin (LMWH) for residual vein thrombosis (RVT) detected at compression ultrasonography (CUS), 6 months after standard anticoagulant treatment. Patients with RVT were deemed at high risk of recurrences and included in the current observational study. They continued LMWH (reduced at 75% standard dose) for further additional 2 years after enrolment or until death. Patients were followed up every 3 months or earlier, if needed. Among ancillary study end points, there was the assessment of patients’ quality of life during daily treatment with subcutaneous injections. Quality of life was determined by the EORTC-C30 questionnaire, administered by a skilled psychologist at enrolment and every 6 months follow-up visits. Overall, 128 patients were evaluated during follow-up. Mean global EORTC-C30 score at enrollment and at 6, 12 and 24 months follow-up were 52.1, 51.4, 50.8 and 50.1, respectively. There were no statistically significant differences between scores at enrolment and at the last available follow-up (P = .1). Long-term treatment with LMWH resulted, effective and safe, it was globally well tolerated and exempt of negative impact on quality of life of the enrolled patients. Reported results support long-term anticoagulant treatment with LMWH in cancer patients at risk of recurrent VTE.

scholarly journals Quality of life after catheter-directed thrombolysis and standard anticoagulation for iliofemoral deep-vein thrombosis

2019 ◽  
Vol 6 (4) ◽  
pp. 274
Author(s):  
MK Ayyappan ◽  
JithinJagan Sebastian ◽  
Pranay Pawar ◽  
Kapil Mathur ◽  
Radhakrishnan Raju ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Deep Vein Thrombosis ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Deep Vein

Patency rate and quality of life after ultrasound-accelerated catheter-directed thrombolysis for deep vein thrombosis

2017 ◽  
Vol 33 (4) ◽  
pp. 251-260 ◽  
Author(s):  
Alexander Gombert ◽  
Ricarda Gombert ◽  
Mohammad E. Barbati ◽  
Philipp Bruners ◽  
Andras Keszei ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Deep Vein Thrombosis ◽  
Patency Rate ◽  
Postthrombotic Syndrome ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Good Patency ◽  
Deep Vein

Purpose Studies on ultrasound-accelerated, catheter-directed thrombolysis of acute deep vein thrombosis emphasize good patency rates and low complication rates. Therefore, we analyzed quality of life besides technical success and patency in our patients after ultrasound-accelerated, catheter-directed thrombolysis. Methods Between 2009 and 2014, 42 patients suffering from iliofemoral deep vein thrombosis received ultrasound-accelerated, catheter-directed thrombolysis. Follow-up included clinical exanimation and ultrasound. Thirty patients (36 interventions), mean age 41.3 years (range 19–71 years), 56.6% women (17/30), completed the surveys. Five different scores were used to assess the quality of life and symptoms of postthrombotic syndrome: SF36, Euro-QOL 5D, PDI, VEINES-QOL/Sym, and the Villalta score. Results Mean therapy duration of ultrasound-accelerated, catheter-directed thrombolysis was 76.4 h and therapeutic success could be reported in 80.5% (29/36). Successful ultrasound-accelerated, catheter-directed thrombolysis was followed by stent angioplasty in 58.3% (21/36) procedures. Overall complication rate was 19.44%, mainly formed by minor bleedings. Mean follow-up was 38.5 months. The primary patency rate was 63.8%, the assisted-primary and the secondary patency rate were 80.5%. We observed an improved quality of life in our patients’ cohort compared to patients suffering from postthrombotic syndrome. Conclusion Although ultrasound-accelerated, catheter-directed thrombolysis is feasible with good patency rates, further prospective randomized trials are necessary to evaluate the value of thrombus removal in iliofemoral deep vein thrombosis in comparison to conservative treatment.

scholarly journals Long-term outcomes after deep vein thrombosis: Postphlebitic syndrome and quality of life

2000 ◽  
Vol 15 (6) ◽  
pp. 425-429 ◽  
Author(s):  
Susan R. Kahn ◽  
Susan Solymoss ◽  
Donna L. Lamping ◽  
Lucien Abenhaim
Keyword(s):  
Quality Of Life ◽  
Deep Vein Thrombosis ◽  
Long Term Outcomes ◽  
Vein Thrombosis ◽  
Postphlebitic Syndrome ◽  
Deep Vein
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