(HealthDay News) — The addition of pharmacomechanical thrombolysis does not reduce the risk of post-thrombotic syndrome among patients with acute proximal deep vein thrombosis, according to a study published in the New England Journal of Medicine.
Suresh Vedantham, MD, from the Washington University School of Medicine in St. Louis, and colleagues randomized 692 patients with acute proximal deep-vein thrombosis to receive anticoagulation alone (control group) or anticoagulation plus pharmacomechanical thrombolysis.
The researchers found observed no significant between-group difference in the percentage of patients with post-thrombotic syndrome between 6 and 24 months (47% in the pharmacomechanical-thrombosis group and 48% in the control group; risk ratio, 0.96; 95% confidence interval, 0.82 to 1.11; P = 0.56). More bleeding events within 10 days occurred in the pharmacomechanical thrombolysis group (1.7 versus 0.3 percent of patients; P = 0.049); over the 24-month period, there was no significant difference in recurrent venous thromboembolism (12 versus 8%; P = 0.09). Moderate-to-severe post-thrombotic syndrome occurred in 18 and 24% of patients in the pharmacomechanical thrombolysis and control groups, respectively (risk ratio, 0.73; 95% confidence interval, 0.54 to 0.98; P = 0.04).
“Among patients with acute proximal deep-vein thrombosis, the addition of pharmacomechanical catheter-directed thrombolysis to anticoagulation did not result in a lower risk of the post-thrombotic syndrome but did result in a higher risk of major bleeding,” the authors write.
Several authors disclosed ties to pharmaceutical companies, some of which provided funding for the study.
Vedantham S, Goldhaber S, Julian JA, et al. Pharmacomechanical catheter-directed thromolysis for deep-vein thrombosis. N Eng J of Med. 2017 Dec 7. doi: 10.1056/NEJMoa1615066