Endovascular treatment of iliofemoral deep venous thrombosis: is there enough evidence to support it? A systematic review with meta-analysis

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Diniz, J (Author) Other; Coelho, A (Author) FMUP; Mansilha A. (Author) FMUP

Journal

The Journal is awaiting validation by the Administrative Services.

Title: INTERNATIONAL ANGIOLOGY

Vol. 39

Pages: 93-104

ISSN: 0392-9590

Publisher: EDIZIONI MINERVA MEDICA

Indexing

ISI Web of Knowledge - 9 Citations

Scopus - 10 Citations

Other information

Authenticus ID: P-00R-Z9C

DOI: 10.23736/s0392-9590.19.04298-6

Abstract (EN): Introduction: Post-thrombotic syndrome (PTS) and iliofemoral (IF) patency reduction are common complications of iliofemoral deep venous thrombosis (IFDVT). Recent studies suggested that endovascular treatment, such as catheter-directed thrombolysis (CDT) and pharmacomechanical thrombectomy (PMT) can effectively reduce the risk and morbidity of PTS in IFDVT patients. This article aims to review the current literature on the subject, focusing on the long-term outcomes of endovascular treatment techniques in IFDVT patients. Evidence acquisition: A thorough systematic review of the literature was conducted using PubMed/Medline and Scopus, according to PRISMA statement guidelines. Forty articles were included, according to their scientific relevance, for the qualitative analysis. From this initial set of articles, nine articles were included for the quantitative analysis. Evidence synthesis: Endovascular treatment with CDT or PMT is related to a decreased risk of PTS development, when compared to standard anticoagulation treatment (OR=0.71; 95% CI=0.54-0.92). Furthermore, IF patency presents superior rates in patients treated with CDT or PMT, instead of anticoagulation (OR=3.20; 95% CI=1.80-5.71). There are no significant differences in the risk of PTS and IF patency between patients treated with CDT and PMT. Complications such as bleeding, pulmonary embolism and death, don't seem to differ between endovascular treatment and anticoagulation, as well as between CDT and PMT procedures. Conclusions: Endovascular techniques seem to have satisfactory long-term outcomes in IFDVT, regarding to PTS risk and IF patency. However, further investigation with prospective randomized clinical trials with large populations and long follow-ups is necessary.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 12