Reporting Standards for Endovascular Treatment of Lower Extremity Deep Vein Thrombosis

Vedantham, Suresh; Ferral, Héctor; Patel, Nilesh H.; Thorpe, Patricia E.; Antonacci, Vittorio P.; d’Othée, Bertrand Janne; Hofmann, Lawrence V.; Cardella, John F.; Kundu, Sanjoy; Lewis, Curtis A.; Schwartzberg, Marc S.; Min, Robert J.; Sacks, David

doi:10.1097/01.rvi.0000197359.26571.c2

Cited by 158 publications

(89 citation statements)

References 75 publications

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“…19 We have previously shown that the percentage of thrombus load reduction was lower in patients with subacute or acute-on-chronic DVT, using the same standardized USAT treatment regimen as in this study. 20 In contrast, Dumantepe et al reported a percentage of thrombus load reduction of ≥50% in 11 out of 12 chronic DVT patients after a mean USAT duration of 26.2±7 hours and a mean r-tPA dose of 42±8 mg (mean symptom duration 92 days; range 34-183).…”

Section: Discussionmentioning

confidence: 99%

“…At the predefined follow-up visit at 3 months, a standardized clinical examination was performed to obtain the Villalta score, 22,23 the revised venous clinical severity score, 24 the Clinical Etiologic Anatomic Pathophysiological score, 25 and the disease-specific quality of life with the Chronic Venous Insufficiency Questionnaire. 19 as successful restoration of antegrade inline flow in the treated vein with elimination of any underlying obstructive lesion at the end of the final endovascular procedure. Primary patency rate was defined as the percentage of patients with primary treatment success and without the occurrence of either thrombosis of the treated segment or a reintervention to maintain patency of the treated segment.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…20 Early rethrombosis was defined as loss of primary-assisted patency within 30 days after the intervention. 19 Safety end points were the incidence of bleeding complications and the recurrence of thromboembolic complications during follow-up. Bleeding complications were classified according to the International Society on Thrombosis and Haemostasis.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…From November 2011 to November 2013, consecutive patients referred to the emergency department or directly to the clinic for angiology with the diagnosis of iliofemoral DVT were screened. Inclusion criteria were the presence of symptomatic proximal DVT involving the iliac or common femoral veins (lower extremity thrombosis classification, LET class III) 18 with symptom duration of <2 weeks 19 and objectively confirmed by Duplex sonography. Exclusion criteria were age <18 years or >75 years; symptom duration >14 days for the DVT episode in the index leg (ie, nonacute DVT); established PTS or previous symptomatic DVT within the last 2 years in the index leg; limb-threatening circulatory compromise; symptomatic pulmonary embolism with hemodynamic compromise (ie, hypotension); inability to tolerate catheter procedure as a result of severe dyspnea or acute systemic illness; allergy, hypersensitivity, or thrombocytopenia from heparin or r-tPA, severe allergy to iodinated contrast; known significant bleeding risk, or known coagulation disorder (including vitamin K antagonists with an international normalized ratio of >2.0 and platelet count <100 000/mm 3 ); severe renal impairment (estimated glomerular filtration rate <30 mL/min); active bleeding, gastrointestinal bleeding <3 months, severe liver dysfunction, or bleeding diathesis; internal eye surgery <3 months or hemorrhagic retinopathy; major surgery, cataract surgery, severe trauma, cardiopulmonary resuscitation, or other invasive procedure <10 days; history of stroke, intracranial or intraspinal bleed, intracranial neoplasm, vascular malformation, or aneurysm; severe hypertension on repeated readings (systolic >180 mm Hg or diastolic >105 mm Hg); pregnancy, lactation, or parturition within the previous 30 days; thrombolytic therapy <1 month; life expectancy <24 months or chronic nonambulatory status.…”

Section: Patients and Study Designmentioning

confidence: 99%

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Ultrasound-Assisted Versus Conventional Catheter-Directed Thrombolysis for Acute Iliofemoral Deep Vein Thrombosis

Engelberger

Spirk

Willenberg

et al. 2015

Circ: Cardiovascular Interventions

113

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Background-For patients with acute iliofemoral deep vein thrombosis, it remains unclear whether the addition of intravascular high-frequency, low-power ultrasound energy facilitates the resolution of thrombosis during catheterdirected thrombolysis. Methods and Results-In a controlled clinical trial, 48 patients (mean age 50±21 years, 52% women) with acute iliofemoral deep vein thrombosis were randomized to receive ultrasound-assisted catheter-directed thrombolysis (N=24) or conventional catheter-directed thrombolysis (N=24). Thrombolysis regimen (20 mg r-tPA over 15 hours) was identical in all patients. The primary efficacy end point was the percentage of thrombus load reduction from baseline to 15 hours according to the length-adjusted thrombus score, obtained from standardized venograms and evaluated by a core laboratory blinded to group assignment. The percentage of thrombus load reduction was 55%±27% in the ultrasoundassisted catheter-directed thrombolysis group and 54%±27% in the conventional catheter-directed thrombolysis group (P=0.91). Adjunctive angioplasty and stenting was performed in 19 (80%) patients and in 20 (83%) patients, respectively (P>0.99). Treatment-related complications occurred in 3 (12%) and 2 (8%) patients, respectively (P>0.99). At 3-month follow-up, primary venous patency was 100% in the ultrasound-assisted catheter-directed thrombolysis group and 96% in the conventional catheter-directed thrombolysis group (P=0.33), and there was no difference in the severity of the post-thrombotic syndrome (mean Villalta score: 3.0±3.

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Section: Discussionmentioning

confidence: 99%

Section: Outcome Measuresmentioning

confidence: 99%

Section: Outcome Measuresmentioning

confidence: 99%

Section: Patients and Study Designmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound-Assisted Versus Conventional Catheter-Directed Thrombolysis for Acute Iliofemoral Deep Vein Thrombosis

Engelberger

Spirk

Willenberg

et al. 2015

Circ: Cardiovascular Interventions

113

View full text Add to dashboard Cite

show abstract

“…The practice of reporting outcomes in mixed populations (eg, combining acute and chronic DVT, nonthrombotic and thrombotic causes, or stent and no stent) was frequently identified during the conduct of the current systematic review and served as a common reason for study exclusion. In accordance with reporting standards set forth by the Society of Interventional Radiology, 50 we recommend that future studies explicitly detail patient outcomes, at a minimum, according to the cause and treatment administered. Furthermore, data elements such as stent location, diameter, length, and quality of venous inflow and outflow should also be systematically recorded.…”

Section: Discussionmentioning

confidence: 99%

Safety and Effectiveness of Stent Placement for Iliofemoral Venous Outflow Obstruction

Razavi

Jaff

Miller

2015

Circ: Cardiovascular Interventions

211

117

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Background-Endovenous recanalization of iliofemoral stenosis or occlusion with angioplasty and stent placement has been increasingly used to maintain long-term venous patency in patients with iliofemoral venous outflow obstruction. The purpose of this systematic review and meta-analysis was to determine safety and effectiveness of venous stent placement in patients with iliofemoral venous outflow obstruction. Methods and Results-We searched MEDLINE and EMBASE for studies evaluating safety or effectiveness of stent placement in patients with iliofemoral venous outflow obstruction. Data were extracted by disease pathogenesis: nonthrombotic, acute thrombotic, or chronic post-thrombotic. Main outcomes included technical success, periprocedural complications, symptom relief at final follow-up, and primary/secondary patency through 5 years. A total of 37 studies reporting 45 treatment effects (nonthrombotic, 8; acute thrombotic, 19; and chronic post-thrombotic, 18) from 2869 patients (nonthrombotic, 1122; acute thrombotic, 629; and chronic post-thrombotic, 1118) were included. Technical success rates were comparable among groups, ranging from 94% to 96%. Complication rates ranged from 0.3% to 1.1% among groups for major bleeding, from 0.2% to 0.9% for pulmonary embolism, from 0.1% to 0.7% for periprocedural mortality, and from 1.0% to 6.8% for early thrombosis. Patient symptom relief data were reported inconsistently. At 1 year, primary and secondary patency were 96% and 99% for nonthrombotic, 87% and 89% for acute thrombotic, and 79% and 94% for chronic post-thrombotic. Conclusions-Stent Methods Literature SearchThis study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. 9 We searched MEDLINE and EMBASE for randomized or nonrandomized controlled studies and prospective or retrospective case series of stent placement for treatment of iliofemoral venous outflow obstruction by using a combination of relevant keywords. The details of the MEDLINE search strategy are listed in Table I in the Data Supplement. The syntax for EMBASE was similar, but adapted as necessary. In addition, manual searches were conducted using the Directory of Open Access Journals, Google Scholar, and the reference lists of included papers and relevant meta-analyses. No date restrictions were applied to the searches. The final search was conducted March 15, 2015. Study SelectionTwo researchers independently selected studies for inclusion in the review. Disagreements were resolved by consensus. Titles and abstracts were initially screened to exclude review articles, commentaries, letters, case reports, and obviously irrelevant studies. Full texts of the remaining articles were retrieved and reviewed. Main inclusion criteria included studies with (1) primary diagnosis of obstructive lesions of the common femoral vein, external iliac vein, and the common iliac vein, (2) stent placement in the common femoral vein, external iliac vein, common iliac vein, and the inferior vena cava, (3) outcomes reporte...

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Thrombolytic strategies versus standard anticoagulation for acute deep vein thrombosis of the lower limb

Broderick

Watson

Armon

2021

Cochrane Database of Systematic Reviews

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BackgroundStandard treatment for deep vein thrombosis (DVT) aims to reduce immediate complications. Use of thrombolytic clot removal strategies (i.e., thrombolysis (clot dissolving drugs) with or without additional endovascular techniques), could reduce the long-term complications of post-thrombotic syndrome (PTS) including pain, swelling, skin discolouration, or venous ulceration in the affected leg. This is the fourth update of the review first published in 2004.

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Reporting Standards for Endovascular Treatment of Lower Extremity Deep Vein Thrombosis

Cited by 158 publications

References 75 publications

Ultrasound-Assisted Versus Conventional Catheter-Directed Thrombolysis for Acute Iliofemoral Deep Vein Thrombosis

Ultrasound-Assisted Versus Conventional Catheter-Directed Thrombolysis for Acute Iliofemoral Deep Vein Thrombosis

Safety and Effectiveness of Stent Placement for Iliofemoral Venous Outflow Obstruction

Thrombolytic strategies versus standard anticoagulation for acute deep vein thrombosis of the lower limb

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