title: A Retrospective Comparison of Ultrasound-Assisted Catheter-Directed Thrombolysis and Catheter-Directed Thrombolysis Alone for Treatment of Proximal Deep Vein Thrombosis.
abstract: BACKGROUND
  Recent studies have suggested that catheter-directed thrombolysis (CDT) reduces development of post-thrombotic syndrome (PTS). Ultrasound-assisted CDT (USCDT) might enhance the efficiency of thrombolysis. We aimed to compare USCDT with CDT on efficacy, safety, development of PTS, and quality of life after long-term follow-up.
  
  
  METHODS
  We describe a retrospective case series of 94 consecutive patients admitted with iliofemoral or more proximal deep vein thrombosis (DVT) to the University Hospital from 2002 to 2011, treated either with CDT or USCDT. Scheduled follow-up visits took place between April 2013 and January 2014. Venography measured the degree of residual luminal obstruction of the affected veins. Each patient completed the Short Form 36-item health survey assessment and the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms questionnaires. PTS was assessed using the Villalta scale.
  
  
  RESULTS
  Risk factors of DVT were equally distributed between groups. In the USCDT group, we observed a significant decline in the duration of thrombolytic treatment (<48 h: 27 vs. 10 %), shortened hospital stay (median 6.0 days (IQR 5.0-9.0) vs. 8.0 (IQR 5.8-12.0)), and less implantation of (intravenous) stents (30 vs. 55 %). There was no difference in patency (76 vs. 79 % fully patent), prevalence of PTS (52 vs. 55 %), or quality of life between groups after long-term follow-up (median 65 months, range: 15-141).
  
  
  CONCLUSIONS
  In this observational study, USCDT was associated with shortened treatment duration, shorter hospital stay, and less intravenous stenting, compared to CDT alone without affecting the long-term prevalence of PTS or quality of life.
authors.affiliation: K. G. Jebsen - Thrombosis Research and Expertise Centre (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, 9037, Tromsø, Norway. ynse.i.tichelaar@uit.no.|Division of Hemostasis and Thrombosis, Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands. ynse.i.tichelaar@uit.no.
authors.forename: Vladimir Y I G
authors.initials: VY
authors.lastname: Tichelaar
authors.affiliation: K. G. Jebsen - Thrombosis Research and Expertise Centre (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, 9037, Tromsø, Norway.|Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Brodin
authors.affiliation: K. G. Jebsen - Thrombosis Research and Expertise Centre (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, 9037, Tromsø, Norway.|Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Anders
authors.initials: A
authors.lastname: Vik
authors.affiliation: K. G. Jebsen - Thrombosis Research and Expertise Centre (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, 9037, Tromsø, Norway.|Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Trond
authors.initials: T
authors.lastname: Isaksen
authors.affiliation: Research Group Epidemiology of Chronic Diseases, Department of Community Medicine, UiT - The Arctic University of Norway, 9037, Tromsø, Norway.
authors.forename: Finn Egil
authors.initials: FE
authors.lastname: Skjeldestad
authors.affiliation: Department of Radiology, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Satish
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Radiology, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Nora C
authors.initials: NC
authors.lastname: Trasti
authors.affiliation: Department of Radiology, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Kulbir
authors.initials: K
authors.lastname: Singh
authors.affiliation: K. G. Jebsen - Thrombosis Research and Expertise Centre (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, 9037, Tromsø, Norway.|Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.
authors.forename: John-Bjarne
authors.initials: JB
authors.lastname: Hansen
mesh_terms: D000328:Adult; D002406:Catheterization, Peripheral / Q000009:adverse effects; D057785:Catheters; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D054070:Postthrombotic Syndrome / Q000517:prevention & control; D011788:Quality of Life; D012189:Retrospective Studies; D015912:Thrombolytic Therapy / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents
keywords: Catheter; Post-thrombotic syndrome; Quality of life; Thrombolysis; Ultrasound; Venous thrombosis