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2014 VEITH Symposium: Ultrasound-Accelerated, Catheter-Directed Thrombolysis for DVT

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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.

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