Early results of thrombolysis vs anticoagulation in iliofemoral venous thrombosis. A randomised clinical trial.
OBJECTIVE
catheter directed thrombolysis has been advocated for complete and rapid dissolution of iliofemoral deep venous thrombosis (DVT). The aim of our study is to compare, in a randomised trial, local thrombolysis and anticoagulation with anticoagulation alone in patients with iliofemoral DVT.


METHODS
a consecutive series of 35 eligible patients, were randomised to either catheter directed thrombolysis followed by anticoagulation or to anticoagulation alone. Clot lysis and deep venous reflux were assessed with ultrasound duplex and plethysmography after 6 months.


RESULTS
complete data were available in the 18 and 17 patients randomised to thrombolysis and anticoagulation, respectively. At 6 months, patency rate was better in cases treated with thrombolysis [13/18 (72%) vs 2/17 (12%), p < 0.001]. Venous reflux was higher in-patients treated with anticoagulant [7 patients (41%) vs 2 (11%), p = 0.04].


CONCLUSIONS
in the short-term patients treated with catheter directed thrombolysis obtained better patency and competence than those treated with standard anticoagulation.
Elsharawy
M
M
Ismailia POB 262, Ismailia 41511, Egypt.
Elzayat
E
E
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D005268:Femoral Vein / Q000187:drug effects* / Q000503:physiopathology; D005500:Follow-Up Studies; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D007084:Iliac Vein / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013300:Streptokinase / Q000627:therapeutic use*; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency / Q000187:drug effects / Q000502:physiology; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000503:physiopathology
D000925:Anticoagulants; D006493:Heparin; D013300:Streptokinase