دورية أكاديمية
Quantity of clot lysed after catheter-directed thrombolysis for iliofemoral deep venous thrombosis correlates with postthrombotic morbidity.
| العنوان: | Quantity of clot lysed after catheter-directed thrombolysis for iliofemoral deep venous thrombosis correlates with postthrombotic morbidity. |
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| المؤلفون: | Grewal NK; Jobst Vascular Center, Toledo, Ohio, USA., Martinez JT, Andrews L, Comerota AJ |
| المصدر: | Journal of vascular surgery [J Vasc Surg] 2010 May; Vol. 51 (5), pp. 1209-14. Date of Electronic Publication: 2010 Mar 27. |
| نوع المنشور: | Comparative Study; Evaluation Study; Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 8407742 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6809 (Electronic) Linking ISSN: 07415214 NLM ISO Abbreviation: J Vasc Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2008-> : New York, NY : Elsevier Original Publication: St. Louis, Mo. : Mosby, [c1984- |
| مواضيع طبية MeSH: | Catheterization, Peripheral* , Femoral Vein* , Iliac Vein*, Fibrinolytic Agents/*therapeutic use , Thrombolytic Therapy/*adverse effects , Venous Thrombosis/*drug therapy, Acute Disease ; Adult ; Aged ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Linear Models ; Male ; Middle Aged ; Morbidity/trends ; Phlebography/methods ; Probability ; Quality of Life ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Survival Rate ; Thrombolytic Therapy/methods ; Treatment Outcome ; Ultrasonography, Doppler, Duplex ; Vascular Patency/drug effects ; Venous Thrombosis/diagnosis ; Venous Thrombosis/mortality ; Venous Thrombosis/therapy |
| مستخلص: | Background: International treatment guidelines now recognize the importance of thrombus removal to reduce postthrombotic morbidity when treating patients with extensive acute deep venous thrombosis (DVT). Studies have shown that thrombus resolution with catheter-directed thrombolysis in patients with iliofemoral DVT reduces postthrombotic morbidity, although patients unsuccessfully treated with catheter-directed thrombolysis (CDT) do not enjoy the same long-term benefit. The purpose of this study is to objectively assess whether the amount of clot reduction at the time of acute therapy correlates with long-term postthrombotic morbidity. Methods: Forty-two patients who underwent catheter-directed and/or pharmacomechanical lysis of iliofemoral DVT were quantitatively evaluated. Patients had their degree of clot lysis quantified and were divided into two main groups for comparison. Group I (n = 33) had >50% clot lysis (mean, 84%) and group II (n = 9) had < or =50% lysis (mean, 42%). At a mean follow-up interval of 14 months, the degree of chronic venous disease was assessed by evaluators blinded to the degree of clot lysis. Evaluation of postthrombotic morbidity was performed using the Villalta scale, and the clinical class of CEAP, and quality-of-life (QOL) was assessed using the Short Form Health Survey (SF-36). Results: Mean CEAP scores were 0.85 and 3.13 (P = .005), and Villalta scores were 2.38 and 6.25 (P = .009) in group I and group II, respectively. Patient QOL in group I was higher than group II in all parameters. Physical functioning (P = .035), role physical (P = .012), general health (P = .014), vitality (P < .001), and social functioning (P = .012) were all significantly better in group I. Bodily pain (P = .117), role emotional (P = .624), and mental health (P = .096) strongly favored group I patients but did not reach statistical significance. Conclusion: Patients with extensive DVT treated with catheter-based interventions to eliminate thrombus suffer relatively little postthrombotic morbidity. The degree of clot lysis directly correlates with long-term outcome. Improved QOL, the Villalta scale, and clinical class of CEAP are linearly correlated with the amount of clot resolution. (Copyright (c) 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.) |
| المشرفين على المادة: | 0 (Fibrinolytic Agents) |
| تواريخ الأحداث: | Date Created: 20100330 Date Completed: 20100512 Latest Revision: 20191210 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.jvs.2009.12.021 |
| PMID: | 20347543 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1097-6809 |
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| DOI: | 10.1016/j.jvs.2009.12.021 |