Abstract:Objective:To evaluate the efficacy and safety of catheter-directed thrombolysis (CDT)compared with traditional treatment(Anticoagulant alone AC)for early(pristine) iliofemoral venous thrombosis (IFVT).
Methods:We searched MEDLINE(OVID,1990 to June 2010), EMBASE(1990 to June 2010),Cochrane Central Register of Controlled Trials(1991 to June 2010), PubMed(1990 to June 2010), Chinese Biomedical Literature Database(CBM), Chinese Scientific Journal, Full-text Database(CSJD), and Chinese Journal Full-text Database(CJFD), added with handsearching and other retrievals. The Cochrane Collaboration′s RevMan 5.0.18 was used for meta-analyses.
Results:Only two randomized controlled trials were available and were included in the study. Meta-analysis showed that 6 months after treatment, iliofemoral vein patency rate of CDT group was higher than that of AC group[45/68 vs. 21/70,OR=4.47,95% CI(2.19,9.12),P<0.0001], the iliofemoral vein occlusion and (or) venous reflux rate of CDT group was less than that of AC group [12/68 vs. 33/70,OR=0.24,95% CI(0.11,0.53),P=0.004]. Major complications of CDT group compared to those of AC group were not statistically significant [2/68 vs. 1/70,OR=1.53,95% CI(0.25,9.24),P=0.65], but the minor complications and total complications of CDT group were higher than those of AC group, [11/68 vs. 2/70,OR=5.48,95% CI(1.33,22.51),P=0.02] and [13/68 vs. 3/70,OR=3.55,95% CI(1.20,10.45),P=0.02].
Conclusions:CDT is a positively effective way to treat early IFVT. Application of CDT in patients without contraindications to its use can have good therapeutic effect.