{"id":44177,"date":"2014-07-21T16:14:49","date_gmt":"2014-07-21T20:14:49","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=44177"},"modified":"2014-07-21T16:14:49","modified_gmt":"2014-07-21T20:14:49","slug":"study-finds-flaws-in-catheter-directed-thrombolysis-for-dvt","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2014\/07\/21\/study-finds-flaws-in-catheter-directed-thrombolysis-for-dvt\/","title":{"rendered":"Study Finds Flaws in Catheter-Directed Thrombolysis for DVT"},"content":{"rendered":"<p>In recent years, catheter-directed thrombolysis (CDT) has been added to the current standard of anticoagulation therapy in some patients with deep vein thrombosis (DVT). The hope was that CDT would help reduce the high rate of post-thrombotic syndrome (PTS), but now an observational study finds no benefits and some important disadvantages associated with CDT.<\/p>\n<p>In <a href=\"http:\/\/archinte.jamanetwork.com\/article.aspx?doi=10.1001\/jamainternmed.2014.3415\">a report published in\u00a0<\/a><em>JAMA Internal Medicine<\/em>, Riyaz Bashir and colleagues analyzed data from 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 (1.2% and 0.9%, respectively; p=0.15). However, the CDT group had significantly higher rates of pulmonary embolism, intracranial hemorrhage, and vena cava filter placement. The CDT group also had longer and more expensive hospital stays.<\/p>\n<p>The authors acknowledge the limitations of observational studies and call for randomized trials &#8220;to evaluate the magnitude of the effect of CDT on outcomes such as mortality, PTS and recurrence of DVT.&#8221; They conclude that CDT &#8220;should be offered only to patients with a low bleeding risk. \u2026 it is imperative that the magnitude of benefit from CDT be substantial to justify the increased initial resource utilization and bleeding risks of this therapy.&#8221;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In recent years, catheter-directed thrombolysis (CDT) has been added to the current standard of anticoagulation therapy in some patients with deep vein thrombosis (DVT). The hope was that CDT would help reduce the high rate of post-thrombotic syndrome (PTS), but now an observational study finds no benefits and some important disadvantages associated with CDT. In [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-44177","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/44177","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=44177"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/44177\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=44177"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=44177"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=44177"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}