Additional catheter-directed venous thrombolysis in iliofemoral deep vein thrombosis; short-term results from the cavent study, a multicenter, randomized controlled trial
Abstract number: AS-MO-007
Enden1 T.R., Slagsvold2 C.E., Kl⊘w3 N.E., Sandset4 P.M.
11Departments of Radiology, Oslo University Hospital, Ullevål 22Department of Vascular Diagnosis and Research, Oslo University Hospital, Aker 33Department of Cardiovascular Radiology 44Department of Hematology, Oslo University Hospital, Ullevål, Oslo, Norway
How-to-cite Enden TR, Slagsvold CE, Kl⊘w NE, Sandset PM. Additional catheter-directed venous thrombolysis in iliofemoral deep vein thrombosis; short-term results from the cavent study, a multicenter, randomized controlled trial. Journal of Thrombosis and Haemostasis 2009; Volume 7, Supplement 2: Abstract AS-MO-007
Background: With anticoagulation and compression stockings approximately one in four patients with acute proximal deep vein thrombosis (DVT) will develop postthrombotic syndrome (PTS). The ongoing CaVenT Study investigates short- and long-term effects of catheter-directed thrombolysis (CDT). Our main hypothesis on short-term effects is that CDT will increase patency of the affected iliofemoral veins after 6 months from < 50% on conventional therapy to > 80% after adjunctive CDT.
Methods/results: From Jan 2006 to Jan 2008, 103 patients (64 male, mean age 52.1 years) were randomized to receive either adjunctive CDT (n = 50) or conventional treatment alone (n = 53). After CDT 50–90% lysis (grade II lysis) was achieved in 20 patients, and complete lysis (grade III) in 24 patients. CDT failed in one patient with agenesis of inferior vena cava, and 1 patient did not comply with the inclusion criterium thrombus extension to the upper half of the thigh at initiation of the procedure. Non-invasive assessment of the veins performed at 6 months follow-up, included ultrasound with Doppler and air plethysmography. Patients with incompressibility of the femoral vein, no venous flow and/or functional venous obstruction were classified as not having regained iliofemoral venous patency. Patients with duplicate femoral veins with at least one branch with normal compressibility and flow were considered successfully recanalized. Venous insufficiency was defined as reflux lasting > 0.5 s Patency of the iliofemoral vein segments was found in 32 (64.0%) patients in the CDT group and 19 (35.8%) in the control group, risk difference (RD) 28.2% (95% CI, 9.7–46.7%, P = 0.004). Functional venous obstruction was found in 10 (20.0%) and 26 (49.1%), RD 29.1% (95% CI, 20.0% to 38.0%, P = 0.004). There were no significant differences regarding the other subcategories of patency (absence of iliofemoral flow and incompressibility of femoral vein), other postthrombotic changes of the iliofemoral veins (wall thickening and echoic content of vein lumen), or femoral venous insufficiency.
Conclusions: Additional CDT increased patency after 6 months. Venous obstruction, but not venous insufficiency, was reduced in the CDT group.
Disclosure of interest: none declared.
To cite this abstract use the following format:
Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number
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