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Catheter-directed thrombolysis for deep vein thrombosis: 2021 update

Vascular medicine (London, England)(2021)

Cited 18|Views25
Abstract
Catheter-directed thrombolysis (CDT) has been utilized as an adjunct to anticoagulant therapy in selected patients with deep vein thrombosis (DVT) for approximately 30 years. CDT used to be limited to patients with DVT causing acute limb threat and those exhibiting failure of initial anticoagulation, but has expanded over time. Randomized trials evaluating the first-line use of CDT for proximal DVT have demonstrated that CDT does not produce a major reduction in the occurrence of post-thrombotic syndrome (PTS) and that it is poorly suited for elderly patients and those with limited thrombus extent or major risk factors for bleeding. However, CDT does offer selected patients with acute iliofemoral DVT improvement in reducing early DVT symptoms, in achieving reduction in PTS severity, and in producing an improvement in health-related quality of life (QOL). Clinical practice guidelines from medical and surgical societies are now largely aligned with the randomized trial results. This review offers the reader an update on the results of recently completed clinical trials, and additional guidance on appropriate selection of patients with DVT for catheter-directed thrombolytic therapy.
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Key words
deep vein thrombosis (DVT),post-thrombotic syndrome,quality of life,thrombolysis,venous thromboembolism (VTE)
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要点】:论文更新了关于导管定向溶栓治疗深静脉血栓的研究,指出该方法在特定病例中能减轻症状和改善生活质量,但并不显著降低后遗症发生率,且不适用于所有患者。

方法】:通过回顾近年来完成的临床试验结果,评估导管定向溶栓治疗在深静脉血栓患者中的效果及适用性。

实验】:分析了随机临床试验结果,并讨论了医学和外科协会的临床实践指南,未提及具体数据集名称。