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Catheter direct thrombolysis (CDT) and ultrasound-facilitated thrombolysis (UAT) are new techniques that facilitate to dissolve thrombus in patients with deep vein thrombosis (DVT). We aimed to do a meta-analysis comparing clinical data between them.
Pub Med, Cochrane and Embase were systematically searched up to June 2016 for all the clinical data that directly compared CDT and UAT for acute DVT of Ileo-femoral veins. Primary outcomes included failure of therapy and recurrence of thrombus. Secondary outcomes included major and minor bleedings, additional angioplasty (PTA+ stent) and mean days of hospital stay. We used Fixed or Random Effect analysis using the Cochrane Handbook of Systematic Reviews and RevMan 5.2 for statistical analysis.
Three clinical studies provided 226 patients; 105 in the CDT and 121 in the UAT. There was no difference in failure of reduction of ≥ 50% thrombus reduction (p=1.0). There was a significant less recurrence thrombus in the UAT group compared to the CDT (11.0% vs. 11.1%, p=0.04). Secondary outcomes showed no difference between groups in terms of length of hospital stay, minor and major bleeding. There was significant less stents required after UAT compared to CDT (42% vs. 59%, p= 0.04).
New thrombolysis techniques can improve outcomes of acute ileo-femoral DVT. UAT not only requires significant less angioplasty with stents but also might be associated with better re-stenosis rates. It is yet to be determined if UAT is clinically superior. Further randomized trials should be pursued.
ENDOVASCULAR: Peripheral Vascular Disease and Intervention