Early results of thrombolysis vs anticoagulation in iliofemoral venous thrombosis. A randomised clinical trial

Eur J Vasc Endovasc Surg. 2002 Sep;24(3):209-14. doi: 10.1053/ejvs.2002.1665.

Abstract

Objective: catheter directed thrombolysis has been advocated for complete and rapid dissolution of iliofemoral deep venous thrombosis (DVT). The aim of our study is to compare, in a randomised trial, local thrombolysis and anticoagulation with anticoagulation alone in patients with iliofemoral DVT.

Methods: a consecutive series of 35 eligible patients, were randomised to either catheter directed thrombolysis followed by anticoagulation or to anticoagulation alone. Clot lysis and deep venous reflux were assessed with ultrasound duplex and plethysmography after 6 months.

Results: complete data were available in the 18 and 17 patients randomised to thrombolysis and anticoagulation, respectively. At 6 months, patency rate was better in cases treated with thrombolysis [13/18 (72%) vs 2/17 (12%), p < 0.001]. Venous reflux was higher in-patients treated with anticoagulant [7 patients (41%) vs 2 (11%), p = 0.04].

Conclusion: in the short-term patients treated with catheter directed thrombolysis obtained better patency and competence than those treated with standard anticoagulation.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anticoagulants / therapeutic use*
  • Female
  • Femoral Vein / drug effects*
  • Femoral Vein / physiopathology
  • Follow-Up Studies
  • Heparin / therapeutic use*
  • Humans
  • Iliac Vein / drug effects*
  • Iliac Vein / physiopathology
  • Male
  • Middle Aged
  • Streptokinase / therapeutic use*
  • Thrombolytic Therapy*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency / drug effects
  • Vascular Patency / physiology
  • Venous Thrombosis / drug therapy*
  • Venous Thrombosis / physiopathology

Substances

  • Anticoagulants
  • Heparin
  • Streptokinase