The Particulars: Interest in catheter-directed thrombolysis to treat lower extremity DVT has led to the development of aggressive approaches using ultrasonic augmentation. However, few studies have compared ultrasound-accelerated, catheter-directed thrombolysis with traditional catheter-directed thrombolysis.
Data Breakdown: Among 77 limbs in 68 patients treated for DVT of a 4-year period, investigators observed the following:
| Catheter-Directed Thrombolysis Type | ||
| Ultrasound-Accelerated | Traditional | |
| Time to lysis | 20.6 hours | 23.8 hours |
| Grade III or complete lysis | 26 limbs | 6 limbs |
| Grade II or incomplete lysis | 19 limbs | 9 limbs |
| Grade I or ineffective lysis | 4 limbs | 10 limbs |
| Thirty-day recurrent thrombosis | 1 patient | 1 patient |
| Free of recurrent DVT at 1 month | 98% | 94% |
| Free of recurrent DVT at 12 months | 94% | 89% |
| Free of recurrent DVT at 24 months | 94% | 89% |
Take Home Pearls: Ultrasound-accelerated, catheter-directed thrombolysis does not appear to expedite lysis. However, the procedure does appear to improve clot clearance in lower extremity DVT when compared with traditional catheter-directed thrombolysis.
