The Effectiveness of Catheter-directed Thrombolysis for First Line Deep Vein Thrombosis Therapy

Kim, Hyung Suk; Kwon, Oh Jung; Song, Sun Young

Abstract

PURPOSE
Untreated deep vein thrombosis (DVT) is associated with morbidity and mortality, such as pulmonary embolism and post-thrombotic syndrome. Anticoagulation therapy is efficient for reducing thrombus propagation but is insufficient for clot lysis or preventing post thrombotic syndrome. Current catheter-directed thrombolysis is an important DVT treatment. We compared the outcomes between anticoagulation therapy and DVT catheter-directed thrombolysis. The purpose of this study was to evaluate treatment outcomes in patients with symptomatic DVT who had undergone catheter-directed thrombolysis.
METHODS
From January 2003 to January 2009, we retrospectively reviewed 91 patients who had been admitted and treated for DVT in our hospital. We divided 91 patients into two groups according to treatment method; 42 patients (46.2%) were treated with only anticoagulation, and 49 patients (53.8%) were treated with catheter-directed thrombolysis. We compared the results of the two treatments groups. The results included gender, symptom onset, age, location, complications, risk factors, days to improved patient symptoms and patency. All patients underwent Doppler sonography or CT-venography at 3 and 6 months to evaluate venous patency after treatment.
RESULTS
49 patients who underwent catheter-directed thrombolysis for DVT had more symptom-relief days (25.00 days, P<0.001). The 43 patients (88%) of the catheter-directed thrombolysis group showed more complete resolution on Doppler sonography or CT-venography after 6 months (P=0.001). We obtained better clinical outcomes in the catheter-directed thrombolysis group than in the anticoagulation only group.
CONCLUSION
Catheter-directed thrombolysis is an effective treatment for acute DVT.