“This treatment regimen is able to clear blood clots rapidly and safely, restoring blood flow in the veins of the lower leg, and the results are durable,” said lead author Richard Chang, M.D., chief of the interventional radiology section of the Department of Radiology, Clinical Center, National Institutes of Health (NIH), Bethesda, Md.
Most patients with DVT are treated solely with anticoagulation therapy and compression stockings. However, studies have shown that one-third of these patients will suffer from post-thrombotic syndrome, characterized by pain, swelling, or in severe cases by changes in skin color or skin ulceration. Another third are likely to have another clot or pulmonary embolism within five years of their initial DVT. Treatments with thrombolytic therapy could potentially protect against these occurrences, but can pose a bleeding risk.
Twenty patients with acute DVT were treated with direct intraclot lacing of the thrombus with a clot-dissolving agent called alteplase and full systemic anticoagulation. Alteplase binds to the clot, so the procedure does not require continuous infusion of the drug, as do some thrombolytic therapies. With this treatment, after lacing one vein segment with alteplase, the interventional radiologist can immediately direct catheters to treat other vein segments to ensure that the entire clot has been adequately treated.
The results of the study showed that blood flow was restored throughout the deep venous system in 16 of the 20 patients during therapy with complete resolution of symptoms in 18 patients after six months of anticoagulation. Alteplase was cleared from the patients’ circulatory system within two hours of treatment, reducing the risk of subsequent bleeding. There were no serious complications or bleeding during the treatment, and no cases of post-thrombotic syndrome or recurrent clotting during follow-up of 3.4 years.
MEDICA.de; Source: Radiological Society of North America