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Study Finds Flaws in Catheter-Directed Thrombolysis for DVT — Physician’s First Watch

Medical News |
July 22, 2014

Study Finds Flaws in Catheter-Directed Thrombolysis for DVT

By Larry Husten

Edited by Jaye Elizabeth Hefner, MD

Catheter-directed thrombolysis (CDT) — added in recent years to the current standard of anticoagulation therapy in some patients with deep vein thrombosis (DVT) — offers no benefits and several important disadvantages, according to a study in JAMA Internal Medicine.

Researchers analyzed data on more than 90,000 patients hospitalized for DVT, 3649 of whom received CDT plus anticoagulation. In-hospital mortality did not differ significantly between the CDT patients and matched controls who received anticoagulation alone. However, the CDT group had significantly higher rates of pulmonary embolism (18% vs. 11%), intracranial hemorrhage (0.9% vs 0.3%), and vena cava filter placement (35% vs. 16%). The CDT group also had longer and more expensive hospital stays.

The authors acknowledge the limitations of observational studies and call for randomized trials "to evaluate the magnitude of the effect of CDT on outcomes such as mortality, [postthrombotic syndrome] and recurrence of DVT."

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