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Procedure May Lower Complications After Leg Clots

A procedure in which doctors use a catheter to help reduce complications after deep vein thrombosis (DVT) appears beneficial, a new Norwegian study found. The study appeared online December 13, 2011, in The Lancet and was presented at the annual meeting of the American Society of Hematology in San Diego.

DVT involves a blood clot in the legs that can travel to the lungs and become even more dangerous. Nearly one-half of patients with a DVT can also develop a cluster of complications called postthrombotic syndrome and characterized by pain, swelling, a sensation of heaviness, and skin deterioration.

The new study included 189 patients with DVT who received either conventional blood-thinning treatment alone or conventional treatment plus additional catheter-directed thrombolysis (CDT) using the powerful clot-busting drug alteplase.

In CDT, X-ray imaging is used to help guide a special medication or medical device to the site of the blood clot to dissolve it, according to the American College of Radiology and the Radiological Society of North America.

After two years of follow-up, complications linked to DVT had occurred in 41% of the patients who received additional CDT and in 56% of those who received conventional treatment alone, according to team members led by Per Morten Sandset, MD, PhD, of the department of hematology at Oslo University Hospital.

That means adding CDT to treatment reduces the rate of complications by about one-quarter. For every seven patients treated with additional CDT, one case of these postclot complications was prevented, the researchers said.

There were 20 bleeding complications associated with the treatment, however, including three major and five clinically relevant bleeds.

The addition of CDT lowered the complication rate for people with DVT compared with those treated with blood thinners alone “but was associated with a small additional risk of bleeding,” the researchers wrote. But compared with standard therapy, “This bleeding risk seems acceptable,” they added.

One expert agreed that the finding could prove valuable. “This study adds to the evidence base that catheter-directed thrombolysis [clot busting] should be routinely offered as a safe and effective treatment for patients” with DVT in the legs, said Robert Lookstein, MD, director of cardiovascular imaging at Mount Sinai Medical Center in New York City.

— Source: The Lancet News Release