scholarly journals AngioJet Thrombectomy Versus Catheter-Directed Thrombolysis for Lower Extremity Deep Vein Thrombosis: A Meta-Analysis of Clinical Trials

2021 ◽  
Vol 27 ◽  
pp. 107602962110055
Author(s):  
Guan Qiang Li ◽  
Lei Wang ◽  
Xi Cheng Zhang
Keyword(s):  
Clinical Trials ◽  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Meta Analysis ◽  
Effective Rate ◽  
Drug Dose ◽  
Duration Of Treatment ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Deep Vein

Early catheter-directed thrombolysis (CDT) for lower extremity deep vein thrombosis (LEDVT) can reduce post-thrombotic morbidity and the AngioJet thrombectomy is a new therapy that can be selected for the treatment of LEDVT. We performed a systematic review and meta-analysis of clinical trials comparing AngioJet versus CDT to assess the efficacy and safety of AngioJet thrombectomy. We systematically searched PubMed and Embase for clinical trials that published before November 1, 2020 and compared AngioJet thrombectomy and CDT in the treatment of LEDVT. We meta-analyzed effective rate of treatment, serious complications, PTS, Villalta score, duration of treatment and drug dose. AngioJet does not result in a significant difference in the effective rate (OR 1.00, CI 0.73-1.36, P = 0.98; I2 = 0%) and complications (OR 1.16 CI 0.84-1.61, P = 0.36; I2 = 39%) compare to CDT. And there was a statistically significant decrease in incidence of PTS (OR 0.58 CI 0.37-0.91, P = 0.02; I2 = 0%) and Villalta score (OR −1.86 CI −3.49 to −0.24, P = 0.02; I2 = 34%) for AngioJet compared to CDT. In addition, there was a statistically significant decrease in duration of the treatment (OR −2.45 CI −2.75 to −2.15, P < 0.0001; I2 = 95%) and drug dose (OR −3.15 CI −3.38 to −2.93, P < 0.0001; I2 = 98%) between AngioJet and CDT. AngioJet results in a low severity of PTS compared to CDT therapy. Moreover, the average duration of treatment and thrombolysis time was shorter in the AngioJet group compared to the CDT group. However, the AngioJet group was not significantly different in effective rate of treatment and serious complications compared to the CDT group.

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

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Wang Li ◽  
Zhang Chuanlin ◽  
Mu Shaoyu ◽  
Chao Hsing Yeh ◽  
Chen Liqun ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Patency Rate ◽  
Meta Analysis ◽  
Case Series ◽  
Eligibility Criteria ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Complete Lysis ◽  
Deep Vein

ABSTRACT 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.

scholarly journals Catheter-Directed Thrombolysis Versus Standard Anticoagulation for Acute Lower Extremity Deep Vein Thrombosis: A Meta-Analysis of Clinical Trials

2017 ◽  
Vol 24 (7) ◽  
pp. 1134-1143 ◽  
Author(s):  
Yongming Lu ◽  
Linyi Chen ◽  
Jinhui Chen ◽  
Tao Tang
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Meta Analysis ◽  
Anticoagulation Therapy ◽  
Postthrombotic Syndrome ◽  
Bleeding Events ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Significant Difference ◽  
Deep Vein

Standard anticoagulant treatment alone for acute lower extremity deep vein thrombosis (DVT) is ineffective in eliminating thrombus from the deep venous system, with many patients developing postthrombotic syndrome (PTS). Because catheter-directed thrombolysis (CDT) can dissolve the clot, reducing the development of PTS in iliofemoral or femoropopliteal DVT. This meta-analysis compares CDT plus anticoagulation versus standard anticoagulation for acute iliofemoral or femoropopliteal DVT. Ten trials were included in the meta-analysis. Compared with anticoagulant alone, CDT was shown to significantly increase the percentage patency of the iliofemoral vein ( P < .00001; I2 = 44%) and reduce the risk of PTS ( P = .0002; I2 = 79%). In subgroup analysis of randomized controlled trials, CDT was not shown to prevent PTS ( P = .2; I2 = 59%). A reduced PTS risk was shown, however, in nonrandomized trials ( P < .00001; I2 = 47%). Meta-analysis showed that CDT can reduce severe PTS risk ( P = .002; I2 = 0%). However, CDT was not indicated to prevent mild PTS ( P = .91; I2 = 79%). A significant increase in bleeding events ( P < .00001; I2 = 33%) and pulmonary embolism (PE) ( P < .00001; I2 = 14%) were also demonstrated. However, for the CDT group, the duration of stay in the hospital was significantly prolonged compared to the anticoagulant group ( P < .00001; I2 = 0%). There was no significant difference in death ( P = .09; I2 = 0%) or recurrent venous thromboembolism events ( P = .52; I2 = 58%). This meta-analysis showed that CDT may improve patency of the iliofemoral vein or severe PTS compared with anticoagulation therapy alone, but measuring PTS risk remains controversial. However, CDT could increase the risk of bleeding events, PE events, and duration of hospital stay.

scholarly journals Pharmacomechanical Thrombectomy Versus Catheter-Directed Thrombolysis for Iliofemoral Deep Vein Thrombosis: A Meta-Analysis of Clinical Trials

2019 ◽  
Vol 25 ◽  
pp. 107602961882119 ◽  
Author(s):  
Tao Tang ◽  
Linyi Chen ◽  
Jinhui Chen ◽  
Tong Mei ◽  
Yongming Lu
Keyword(s):  
Clinical Trials ◽  
Deep Vein Thrombosis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Minor Bleeding ◽  
Bleeding Events ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Significant Difference ◽  
Deep Vein

Early catheter-directed thrombolysis (CDT) for deep vein thrombosis (DVT) can reduce postthrombotic morbidity. Pharmacomechanical thrombolysis (PMT) is a new therapy that can be selected for the treatment of iliofemoral deep vein thrombosis (IFDVT). We performed a meta-analysis of clinical trials comparing PMT versus CDT for treatment of acute IFDVT. Literature on this topic published between January 1, 1990, and June 1, 2018, was identified using PubMed, Embase, Cochrane Library, and Web of Science. Six trials were included in the meta-analysis. Compared to CDT, PMT significantly reduced the Villalta score ( P = .007; I2 = 0%), thrombus score ( P = .01; I2 = 0%), the duration in the hospital ( P = .03; I2 = 64%), and thrombolysis time ( P < .00001, I2 = 0%). There was no significant difference in valvular incompetence events ( P = .21; I2 = 0%), minor bleeding events ( P = .59; I2 = 0%), stent events ( P = .09; I2 = 24%), and clot reduction grade I events ( P = .16; I2 = 43%) between PMT and CDT. Subgroup analysis was performed by dividing the clot reduction grade I events group into PMT plus CDT versus CDT group and significant differences were found ( P = .03, I2 = 0%) as well as for PMT alone versus CDT group ( P = .88, I2 = 37%). This meta-analysis shows that PMT reduces the severity of postthrombotic syndrome (PTS), thrombus score, duration in hospital, and thrombolysis time compared to CDT. More specifically, PMT plus CDT reduces clot reduction grade I events. No significant difference in valvular incompetence events, stent events, and minor bleeding events were found when PMT was compared to CDT.

An Imaging Approach to Deep Vein Thrombosis and the Lower Extremity Thrombosis Classification

2012 ◽  
Vol 27 (1_suppl) ◽  
pp. 143-148 ◽  
Author(s):  
C W K P Arnoldussen ◽  
C H A Wittens
Keyword(s):  
Clinical Trials ◽  
Deep Vein Thrombosis ◽  
Natural History ◽  
Lower Extremity ◽  
Systematic Approach ◽  
Vein Thrombosis ◽  
Natural History Studies ◽  
Imaging Approach ◽  
Deep Vein

In this article we want to discuss the potential of lower extremity deep vein thrombosis (DVT) imaging and propose a systematic approach to DVT management based on a DVT classification of the lower extremity; the LET classification. Identifying and reporting DVT more systematically allows for accurate stratification for initial patient care, future clinical trials and appropriate descriptions for natural history studies.

scholarly journals Diagnostic accuracy of three ultrasonography strategies for deep vein thrombosis of the lower extremity: A systematic review and meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. e0228788 ◽  
Author(s):  
Noémie Kraaijpoel ◽  
Marc Carrier ◽  
Grégoire Le Gal ◽  
Matthew D. F. McInnes ◽  
Jean-Paul Salameh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Vein Thrombosis ◽  
Deep Vein

A case-controlled study on AngioJet rheolytic thrombectomy and catheter-directed thrombolysis in the treatment of acute lower extremity deep venous thrombosis

Vascular ◽  
2019 ◽  
Vol 28 (2) ◽  
pp. 177-182 ◽  
Author(s):  
Jun Zhu ◽  
Cai-Fang Ni ◽  
Zhen-Yu Dai ◽  
Li-Zheng Yao ◽  
Wen-Hui Li
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Controlled Study ◽  
Efficacy And Safety ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Rheolytic Thrombectomy ◽  
Thrombus Removal ◽  
The Mean ◽  
Deep Vein

Objective This study aims to compare the efficacy and safety of AngioJet rheolytic thrombectomy vs. catheter-directed thrombolysis in patients with acute lower extremity deep vein thrombosis. Methods Between the period of February 2015 and October 2016, 65 patients with documented acute lower extremity deep vein thrombosis were treated with catheter-directed intervention. These patients were divided into two groups: AngioJet group and catheter-directed thrombolysis group. Comparisons were made with regard to efficacy and safety between these two groups. Results In the AngioJet group, complete or partial thrombus removal was accomplished in 23 (72%) and 3 (9%) patients, respectively. In the catheter-directed thrombolysis group, complete or partial thrombus removal was accomplished in 27 (82%) patients and 1 (3%) patient, respectively. In the AngioJet group, the perimeter difference between the suffered limb and healthy one declined from 5.1 ± 2.3 cm to 1.4 ± 1.2 cm ( P <  0.05). In the catheter-directed thrombolysis group, the perimeter difference declined from 4.7 ± 1.6 cm to 1.5 ± 0.9 cm ( P <  0.05). The mean urokinase dose was 0.264 ± 0.135 million units in the AngioJet group and 1.869 ± 0.528 million units in the catheter-directed thrombolysis group ( P <  0.05). The duration of thrombolysis was 4.2 ± 1.7 h in the AngioJet group and 73.6 ± 18.3 h in the catheter-directed thrombolysis group ( P <  0.05). The occurrence of complications in these two groups was 19% and 18%, respectively (not significant). Conclusion AngioJet rheolytic thrombectomy is a new, safe and effective approach for treating acute lower extremity deep vein thrombosis. When compared to catheter-directed thrombolysis, this treatment provides similar success with lower urokinase dosage and shorter duration of thrombolysis.

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