Vasc Spec Int.  2019 Mar;35(1):28-33. 10.5758/vsi.2019.35.1.28.

Comparison of Treatment Result Between Anticoagulation Alone and Catheter-Directed Thrombolysis Plus Anticoagulation in Acute Lower Extremity Deep Vein Thrombosis

Affiliations
  • 1Endovascular and Vascular Division, Department of Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea. goodsight@empas.com

Abstract

PURPOSE
Deep vein thrombosis (DVT) is the third most common cause of cardiovascular morbidity and mortality. Anticoagulation has been the primary treatment modality for acute DVT. However, catheter-directed thrombolysis (CDT) has recently become widely accepted as an additional therapy to anticoagulation. We assessed comparative outcomes in patients with acute DVT who underwent anticoagulation therapy alone (ACA) group and those treated with CDT group.
MATERIALS AND METHODS
We retrospectively reviewed medical records of 149 patients with DVT from January 2011 to December 2015. We compared patients who received ACA group (n=120) and those who received CDT plus anticoagulation (CDT group, n=29). We analyzed the prevalence of lesions, thrombus removal rate in each lesion, and recurrence-free rate between the two groups.
RESULTS
We found thrombus involvement in a total of 281 lesions in the ACA group and 85 lesions in the CDT group. For the distribution of lesions in each group, those in the femoral vein accounted for 34.2% of all lesions and those in the popliteal vein accounted for 31.7%. During follow-up, the overall thrombus removal rate was 91.1% in the ACA group and 87.0% in the CDT group (P=0.273). The recurrence-free rate was higher in the CDT group in a log-rank test; however, there was no statistically significant difference between the two groups (P=0.594).
CONCLUSION
According to our results, there was no significant difference in thrombus removal and recurrence-free rates between the CDT and ACA groups. ACA still has an important role in the treatment of DVT.

Keyword

Venous thrombosis; Anticoagulants; Thrombolytic therapy

MeSH Terms

Anticoagulants
Femoral Vein
Follow-Up Studies
Humans
Lower Extremity*
Medical Records
Mortality
Popliteal Vein
Prevalence
Retrospective Studies
Thrombolytic Therapy
Thrombosis
Venous Thrombosis*
Anticoagulants
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