• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home Uncategorized

Catheter thrombolysis + anticoagulation may be inferior to anticoagulation alone in DVT

byAnees DaudandJames Jiang
July 23, 2014
in Uncategorized
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. There was no significant difference in in-hospital mortality amongst patients who underwent catheter-directed thrombolysis (CDT) in addition to anticoagulation, compared to anticoagulation alone in lower extremity proximal deep vein thrombosis (DVT). 

2. The use of CDT and anticoagulation compared to anticoagulation alone was associated with greater bleeding risk, pulmonary embolism, vena cava filter placement, and total hospital days/charges. 

Evidence Rating Level: 2 (Good)            

Study Rundown: Deep vein thromboses (DVTs) are a major cause of cardiovascular morbidity and mortality. In those patients who have proximal DVTs (popliteal vein or above), many go on to develop postthrombotic syndrome in spite of anticoagulation. Some smaller studies have suggested that catheter-directed thrombolysis (CDT) may lead to improved outcomes and quality of life. This retrospective observational study showed no difference in in-hospital mortality amongst patients who underwent CDT in addition anticoagulation, compared to anticoagulation alon. In fact, CDT plus anticoagulation was associated with more bleeding complications, vena cava filter placements, and total hospital days and charges.

The strength of the study was the overall number of DVT cases they were able to include in the analysis. However, since CDT is not a heavily used procedure, this group was a small percentage of the population. Although the investigators attempted to control for a number of confounding variables, the nature of an observational study is such that it is impossible to account for the inherent differences in the CDT group versus the anticoagulation group. In addition, the investigators relied entirely on ICD9 codes to identify the appropriate diagnoses, which may not have been adequate to identify the appropriate patient population.

Click to read the study, published today in JAMA Internal Medicine

Relevant Reading: Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial

RELATED REPORTS

Dual antiplatelet therapy discontinued 9 months after percutaneous coronary intervention associated with improved morbidity and mortality

Concordance of diagnosis of autism spectrum disorder made by pediatricians vs multidisciplinary specialist teams

Cystatin C-based equation without race or sex improves accuracy of GFR estimation

In-Depth [retrospective cohort]: This retrospective database review examined patients from the Nationwide Inpatient Sample (NIS) files of the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project, from January 2005 to December 2010, including roughly 1000 hospitals in 45 states. Patients were identified via ICD9 codes for proximal DVT, and those who had a pulmonary embolism were excluded. The CDT group had different demographic characteristics and comorbidities, and propensity-matching was used to create two matched groups. The primary end point was in-hospital mortality. Secondary end points included development of a pulmonary embolism, blood transfusion requirements, gastrointestinal bleeding, intracranial bleeding, procedure-related hematomas, vena cava filter placements, length of stay, and hospital charges.

A total of 90,618 cases were identified, of which 3649 (4.1%) underwent CDT and anticoagulation. The adjusted in-hospital mortality rates for the CDT group (1.2%) were not significantly different compared to anticoagulation alone (0.9%) (OR, 1.4; 95% CI, 0.88-2.25). The rates of blood transfusion (11.1% vs 6.5%, P<0.001), pulmonary embolism (17.9% vs 11.4%, P<0.001), intracranial hemorrhage (0.9% vs 0.3%, P=0.03), and vena cava filter placement (34.8% vs 15.6%, P<0.001) were significantly higher in the CDT group. In addition, the CDT group also had longer mean length of stay (7.2 vs 5.0, P<0.001) and higher mean hospital cost. It was noted that in centers that performed more than 5 CDT cases per year, there was significantly lower in-hospital mortality as compared to centers who did 5 or fewer CDT cases per year.

More from this author: Pediatric brain injury unlikely with isolated loss of consciousness, Ultrasound, flow reserve guided coronary interventions provide minimal benefit, Resveratrol levels not linked with decreased mortality (InCHIANTI Trial), Children’s exposure to violence and delinquency likely declined in past decade, Neonatal screening may be effective for salt wasting congenital adrenal hyperplasia 

Image: CC/Wiki/Blausen

©2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.  

Previous Post

Millennium Declaration successful in reducing global burden of HIV, malaria, and TB

Next Post

Home initiation of HIV care increases anti-retroviral therapy use in Malawi

RelatedReports

Drug-coated balloons are noninferior to drug-eluting stents for treatment of small vessel coronary artery disease
Cardiology

Dual antiplatelet therapy discontinued 9 months after percutaneous coronary intervention associated with improved morbidity and mortality

February 4, 2023
Quick Take: Association of Prenatal Exposure to Air Pollution with Autism Spectrum Disorder
Neurology

Concordance of diagnosis of autism spectrum disorder made by pediatricians vs multidisciplinary specialist teams

February 3, 2023
Intravenous contrast may not increase risk of acute kidney injury
Chronic Disease

Cystatin C-based equation without race or sex improves accuracy of GFR estimation

February 3, 2023
#VisualAbstract: Aldosterone synthase inhibition reduced systolic blood pressure in patients with treatment-resistant hypertension
StudyGraphics

#VisualAbstract: Aldosterone synthase inhibition reduced systolic blood pressure in patients with treatment-resistant hypertension

February 3, 2023
Next Post
Home initiation of HIV care increases anti-retroviral therapy use in Malawi

Home initiation of HIV care increases anti-retroviral therapy use in Malawi

High hepatitis B antigen predicts hepatic cancer recurrence

Sofosbuvir aids hepatitis C treatment in patients with HIV

Lower vulvar cancer-related mortality in African Americans

Sirolimus may prevent graft failure in patients with renal transplant for antiphospholipid syndrome

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Dual antiplatelet therapy discontinued 9 months after percutaneous coronary intervention associated with improved morbidity and mortality
  • Concordance of diagnosis of autism spectrum disorder made by pediatricians vs multidisciplinary specialist teams
  • Cystatin C-based equation without race or sex improves accuracy of GFR estimation
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options