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-AcceleratedTraditional
Time to lysis20.6 hours23.8 hours
Grade III or complete lysis26 limbs6 limbs
Grade II or incomplete lysis19 limbs9 limbs
Grade I or ineffective lysis4 limbs10 limbs
Thirty-day recurrent thrombosis1 patient1 patient
Free of recurrent DVT at 1 month98%94%
Free of recurrent DVT at 12 months94%89%
Free of recurrent DVT at 24 months94%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.