Total preservation of patency and valve function after percutaneous pharmacomechanical thrombolysis using the Trellis<sup>®</sup>-8 system for an acute, extensive deep venous thrombosis

Wormald, J.; Lane, Tristan; Herbert, Paul; Ellis, Mary; Burfitt, N; Franklin, Ian J.

doi:10.1308/003588412x13171221589496

Cited by 5 publications

(23 citation statements)

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“…Alternative definitions were used by Sharifi et al 14,15 (presence of ≥two symptoms [leg burning, pain, aches, discomfort, restlessness, and tingling] combined with edema and venous reflux [classified as mild PTS], skin hyperpigmentation or lipodermatosclerosis [classified as moderate PTS], or an active or healed ulcer [classified as severe PTS]) and Manninen et al 22 (abnormal functioning of the venous system because of valvular incompetence with or without associated venous obstruction in a limb with a prior objectified DVT). In one study 57 and four case reports, 63,65,66,71 the definition of PTS was not specified but only the absence of the PTS was reported. Three of these case reports merely described that patients were free of symptoms during follow‐up 63,65,66 …”

Section: Discussionmentioning

confidence: 99%

“…Full-dose anticoagulant treatment based on VKA or DOAC was prescribed in 33 studies (59%). 2,3,[10][11][12][13][16][17][18][19][20][21][22]24,[26][27][28]33,[35][36][37][38][39]44,[46][47][48][49][50]52,[54][55][56]58,[61][62][63]66,71 Generally, VKA in the acute phase was initiated with concurrent use of LMWH for a limited number of days or until the international normalized ratio was stabilized at an intensity of 2.0 to 3.0.…”

Section: Antithrombotic Managementmentioning

confidence: 99%

“…Patency rates were reported in 40 studies (71%) ( Nineteen studies (34%) 16,20,22,24,26,28,35,37,45,52,56,57,59,63,[65][66][67]70,71 included only patients who received an intervention for acute DVT. Five studies 26,28,37,45,56 reported patency using the definitions primary patency, assisted primary patency, and/or secondary patency.…”

Section: Patency Ratesmentioning

confidence: 99%

“…59 All six case reports reported patent stents 63,65,70,71 or stents without (residual) signs of DVT. 66,67 Another 21 studies 23,25,27,[29][30][31][32][33][34][38][39][40][42][43][44][46][47][48][49][50]53,60,62 included a mixed case load with patients treated for thrombotic (acute or chronic) or nonthrombotic venous pathology. Outcomes were mostly reported as primary patency, assisted primary patency, and secondary patency.…”

Section: Patency Ratesmentioning

confidence: 99%

“…Information regarding reVTE was provided in 41 studies (73%) 3,23,27,30,32,33,38,39,41,43,44,46,47,[49][50][51]55,60 ; 23 of these studies included patients treated for acute DVT. 2,[10][11][12][13][14][15][16][17][18][19][20][21][22]24,26,28,35,36,45,52,54,57,63,66,67,70 (Table 3). Studies used different definitions for reVTE, which could include reDVT, IST, PE, and/or the use of inferior caval vein filters.…”

Section: Recurrent Venous Thromboembolismmentioning

confidence: 99%

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Postinterventional antithrombotic management after venous stenting of the iliofemoral tract in acute and chronic thrombosis: A systematic review

Notten

Cate

Cate‐Hoek

2021

Journal of Thrombosis and Haemostasis

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Venous stenting has become a common treatment option for central deep venous outflow obstructions and postthrombotic syndrome. Following successful recanalization and stenting, stent patency is endangered by in‐stent thrombosis and recurrent venous thromboembolism. Antithrombotic therapy might reduce patency loss. This systematic review summarizes the literature on antithrombotic therapy following (post)thrombotic venous stenting. A systematic PubMed, MEDLINE, EMBASE, and Cochrane search was performed for studies addressing antithrombotic therapy prescribed following venous stenting of the iliofemoral tract indicated by acute or chronic thrombotic pathology. A total of 277 articles was identified of which 64 (56 original studies) were selected. Overall, a mean primary patency rate of 82.3% was seen 1 year after the intervention, which decreased to 73.3% after 2 years. In the majority (43 of 56 studies, 77%), treatment was based on use of vitamin K antagonists, either with (18%) or without (59%) use of antiplatelet drugs. Only two studies (4%) directly assessed the effect of antithrombotic therapy on treatment outcomes. The impact of postinterventional antithrombotic therapy on stent patency remains unknown because of limited and insufficient data available in current literature. Further clinical research should more clearly address the role of antithrombotic therapy for preservation of long‐term patency following venous stenting.

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Section: Discussionmentioning

confidence: 99%

Section: Antithrombotic Managementmentioning

confidence: 99%

Section: Patency Ratesmentioning

confidence: 99%

Section: Patency Ratesmentioning

confidence: 99%

Section: Recurrent Venous Thromboembolismmentioning

confidence: 99%

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Postinterventional antithrombotic management after venous stenting of the iliofemoral tract in acute and chronic thrombosis: A systematic review

Notten

Cate

Cate‐Hoek

2021

Journal of Thrombosis and Haemostasis

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A Retrospective Study Comparing 2 Approaches to Catheter-Directed Thrombolysis for Acute Deep Venous Thrombosis

Wang

Chen

et al. 2018

Annals of Vascular Surgery

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The good, bad and the ugly of the Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis trial from the viewpoint of clinicians

Staniszewska

Onida

Lane

et al. 2020

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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Acute deep venous thrombosis (DVT) can be complicated by post-thrombotic syndrome, which is associated with significant morbidity and healthcare costs. The Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) was the largest and most controversial randomized controlled trial evaluating the use of pharmacomechanical catheter-directed thrombolysis (CDT) for the prevention of post-thrombotic syndrome after acute DVT. This study aimed to evaluate clinicians' opinion on the ATTRACT trial and its impact on clinical practice. MethodsAn online survey consisting of 10 core multiple choice items and a maximum of 5 follow-up open-ended questions was delivered to vascular surgeons, interventional radiologists, hematologists, and interventional cardiologists affiliated with 10 international societies between April 23 and July 1, 2019. Clinicians' views on the main limitations of the ATTRACT trial, its impact on patient selection for thrombolysis and the need for a new trial were evaluated. ResultsOut of 15,650 contacted clinicians, 451 (3%) completed the survey, with 74% vascular surgeons, 24% interventional radiologists, 2% hematologists, and 0.2% interventional cardiologists. The majority of respondents (79%) were aware of the results of the ATTRACT trial before completing the survey and routinely performed pharmacomechanical CDT (PCDT) in their centers (70%). Only 20% of clinicians considered ATTRACT to be a welldesigned and well-performed trial. The inclusion of femoropopliteal DVT was reported as the main limitation of the trial by 55% of respondents. Despite half of the participating clinicians reporting no change in their clinical practice, equal number of clinicians (14%) were encouraged and discouraged from treating iliofemoral DVT. More than one-half of the respondents thought that the use of PCDT would be defensible in a court of law despite the increased risk of bleeding reported in the study. Nearly two-thirds of participating clinicians recommended performing a trial limited to iliofemoral DVT, with a follow-up period of 5 years, quality of life as the primary outcome measure, and standardization of thrombolysis protocol across the trial sites. ConclusionsATTRACT failed to provide the long-awaited indisputable evidence on the use of PCDT. Surveyed clinicians were aware of the limitations of this trial and the need for further evidence on the subject.Deep venous thrombosis (DVT) is an important healthcare concern, with an annual incidence of approximately 1 in 2000 in the general population resulting in a 2% to 5% lifetime risk. 1,2 In addition to often severe localized symptoms, it can be complicated by well-recognized life-threatening pulmonary embolism in the acute setting or frequently debilitating post-thrombotic syndrome (PTS) in the longer term. 3 PTS, which is associated with significant impairment in quality of life and considerable healthcare costs, is estimated to affect almost 50% of patients in the first 2 years after an acute episode of DVT despite adequ...

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Total preservation of patency and valve function after percutaneous pharmacomechanical thrombolysis using the Trellis^®-8 system for an acute, extensive deep venous thrombosis

Cited by 5 publications

References 3 publications

Postinterventional antithrombotic management after venous stenting of the iliofemoral tract in acute and chronic thrombosis: A systematic review

Postinterventional antithrombotic management after venous stenting of the iliofemoral tract in acute and chronic thrombosis: A systematic review

A Retrospective Study Comparing 2 Approaches to Catheter-Directed Thrombolysis for Acute Deep Venous Thrombosis

The good, bad and the ugly of the Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis trial from the viewpoint of clinicians

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Total preservation of patency and valve function after percutaneous pharmacomechanical thrombolysis using the Trellis®-8 system for an acute, extensive deep venous thrombosis

Cited by 5 publications

References 3 publications

Postinterventional antithrombotic management after venous stenting of the iliofemoral tract in acute and chronic thrombosis: A systematic review

Postinterventional antithrombotic management after venous stenting of the iliofemoral tract in acute and chronic thrombosis: A systematic review

A Retrospective Study Comparing 2 Approaches to Catheter-Directed Thrombolysis for Acute Deep Venous Thrombosis

The good, bad and the ugly of the Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis trial from the viewpoint of clinicians

Contact Info

Product

Resources

About

Total preservation of patency and valve function after percutaneous pharmacomechanical thrombolysis using the Trellis^®-8 system for an acute, extensive deep venous thrombosis