Saricaoglu Mehmet Cahit, Hasde Ali Ihsan, Karacuha Ali Fuat, Kayan Ahmet, Buyukcakır Onur, Akca Fatma, Ozcinar Evren, Baran Cagdas, Inan Mustafa Bahadir, Sirlak Mustafa, Yazicioglu Levent, Akar Ahmet Ruchan, Eryilmaz Sadik
Department of Cardiovascular Surgery, Heart Center, Cebeci Hospitals, Ankara University School of Medicine, 06340 Ankara, Turkey.
Department of Cardiovascular Surgery, Trabzon Kanuni Education and Research Hospital, 61250 Trabzon, Turkey.
J Clin Med. 2025 May 9;14(10):3298. doi: 10.3390/jcm14103298.
Deep vein thrombosis (DVT) is an important component of venous thromboembolism and can lead to pulmonary embolism with high morbidity and mortality. Anticoagulant therapy alone (AC) and catheter-directed thrombolysis (CDT) are commonly used strategies for the management of DVT. Although CDT has been reported to be effective in reducing the risk of post-thrombotic syndrome (PTS), it remains unclear in which patient groups it should be preferred due to the risk of bleeding. This retrospective study included 175 patients diagnosed with DVT between 2015 and 2024 (98 AC, 77 CDT). Patients with a diagnosis of proximal DVT, aged ≥18 years, and with at least 30 days of follow-up data were included. The primary endpoint was 30-day mortality and secondary endpoints were the length of hospitalization, pulmonary embolism, and bleeding complications. The CDT group was superior to AC in thrombus clearance rates, especially in iliac vein thrombosis (97.7% vs. 78%, = 0.003). Clinical symptoms improved faster in the CDT group, but total hospitalization was longer. There were no significant differences in bleeding complications and mortality rates between the two groups. The optimal approach to DVT treatment should be based on the patient's individual risk factors. Although CDT provides a higher thrombus clearance rate, especially in iliac vein thrombosis, it may not be suitable for all patients. Future large-scale studies will contribute to a better understanding of the long-term outcomes of interventional therapies.
深静脉血栓形成（DVT）是静脉血栓栓塞的重要组成部分，可导致具有高发病率和死亡率的肺栓塞。单纯抗凝治疗（AC）和导管定向溶栓（CDT）是DVT治疗中常用的策略。尽管据报道CDT在降低血栓后综合征（PTS）风险方面有效，但由于出血风险，在哪些患者群体中应优先选择CDT仍不清楚。这项回顾性研究纳入了2015年至2024年间诊断为DVT的175例患者（98例接受AC治疗，77例接受CDT治疗）。纳入诊断为近端DVT、年龄≥18岁且有至少30天随访数据的患者。主要终点是30天死亡率，次要终点是住院时间、肺栓塞和出血并发症。CDT组在血栓清除率方面优于AC组，尤其是在髂静脉血栓形成方面（97.7%对78%，P = 0.003）。CDT组临床症状改善更快，但总住院时间更长。两组在出血并发症和死亡率方面无显著差异。DVT治疗的最佳方法应基于患者的个体风险因素。尽管CDT提供了更高的血栓清除率，尤其是在髂静脉血栓形成方面，但它可能并不适用于所有患者。未来的大规模研究将有助于更好地了解介入治疗的长期结果。
