Individualised Versus Standard Duration of Elastic Compression Therapy for Prevention of Post-Thrombotic Syndrome (IDEAL DVT): A Multicentre, Randomised, Single-Blind, Allocation-Concealed, Non-Inferiority Trial

Cate‐Hoek, Arina J. ten; Amin, Elham E.; Bouman, A.C.; Meijer, Karina; Tick, Lidwine W.

doi:10.1016/j.jvsv.2018.03.005

Cited by 12 publications

(21 citation statements)

References 33 publications

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“…Time to compression was within 24 hours of the diagnosis. There were three prespecified protocols for compression in the acute phase . Initial compression was associated with a 15% relative reduction of (predominantly irreversible) skin signs.…”

Section: Thrombus Resolutionmentioning

confidence: 99%

“…The incidences of PTS were 28.9% and 27.8%, respectively. The absolute difference was 1.1% (95% CI upper limit of 7.2%), thereby not exceeding the upper limit of the predefined noninferiority margin of 7.5% . The IDEAL study essentially confirmed the findings of the previous management study, concluding that individualized shortened duration of compression for 6 months is similar to standard duration of compression for 24 months.…”

Section: Barriers To Progress and Future Perspectivesmentioning

confidence: 99%

“…With a diagnosis based on just one assessment, patients will more often be diagnosed as having PTS; most of these patients will be classified as having mild PTS. 19 For the incidence of moderate and severe PTS it makes no difference, which definition of the Villalta score is used as the observed symptoms and signs are less likely to be reversible.…”

Section: Lack Of Gold Standard For the Diagnosismentioning

confidence: 99%

“…There were three prespecified protocols for compression in the acute phase. 19 Initial compression was associated with a 15% relative reduction of (predominantly irreversible) skin signs. Compression therapy was anticipated to positively influence HRQoL.…”

Section: Isth Berlin 2017 Reportsmentioning

confidence: 99%

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Prevention and treatment of the post‐thrombotic syndrome

Cate‐Hoek

2018

Research and Practice in Thrombosis and Haemostasis

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Essentials Post thrombotic syndrome (PTS) is a complication of deep vein thrombosis (DVT) with limited treatment options.Uniformity of the diagnostic strategy and the use of risk prediction models might improve treatment outcomes.Extending knowledge on the pathophysiology and improving therapeutic options is paramount for progress. PTS management should evolve to a multimodal approach with treatment tailored to individual patients' needs. Post thrombotic syndrome (PTS) is a common chronic complication of deep vein thrombosis of the leg (DVT). Treatment options are limited therefore emphasis is placed on its prevention. Several risk factors have been recognized, but were so far not used for risk stratification or translation into prediction models. Early interventions did not yet result in more successful preventive treatment strategies; for the acute phase of DVT there is equipoise on the value of elastic compression, as well as on catheter directed thrombolysis. There are no drugs specifically targeted at PTS prevention. The use of anticoagulant medication such as direct oral anticoagulants (DOACs) might decrease PTS incidence, but this needs to be corroborated. Both research into more effective treatment options as well as future PTS management may benefit from a uniform diagnostic strategy and the use of prediction rules to better allocate treatment and thereby increase treatment efficacy.

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Section: Thrombus Resolutionmentioning

confidence: 99%

Section: Barriers To Progress and Future Perspectivesmentioning

confidence: 99%

Section: Lack Of Gold Standard For the Diagnosismentioning

confidence: 99%

Section: Isth Berlin 2017 Reportsmentioning

confidence: 99%

See 2 more Smart Citations

Prevention and treatment of the post‐thrombotic syndrome

Cate‐Hoek

2018

Research and Practice in Thrombosis and Haemostasis

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“…This study was an a priori-planned substudy of the IDEAL DVT study, which has been described in detail previously [15]. In short, the IDEAL DVT study was a multicenter randomized controlled trial that started in April 2011 and was concluded in July 2017.…”

Section: Study Design and Population Centermentioning

confidence: 99%