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|
|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.