Ultrasound-Assistant Thrombolysis Promises Treatment of Extensive Deep Vein Thrombosis

According to recent findings, the use of ultrasound may help decrease the total dose of lytic agents used for the treatment of deep vein thrombosis (DVT) or acute limb ischemia.

Karthikeshwar Kasirajan, M.D., assistant professor of surgery at the Emory University School of Medicine (Atlanta, GA, USA), presented the results of his research conducted to evaluate the safety and efficacy of ultrasound as an adjunct to facilitate pharmacologic thrombolysis at the Veith Symposium held in New York, NY, USA, in November 2008.

From December 2006 to August 2008, 37 patients (16 with deep vein thrombosis, and 21 with acute in situ arterial thrombosis) were treated with catheter direct pharmacologic thrombolysis using 0.5 mg/hour of the recombinant tissue plasminogen activator (Alteplase, developed by Genentech, San Francisco, CA, USA) via the Ekos (Bothell, WA, USA) infusion system.

Complete thrombus resolution was noted in all arterial patients. Four patients with DVT had partial thrombus (40%) resolution; two patients had no change and all others had complete thrombus resolution.

The Veith Symposium was designed to provide vascular surgeons, interventional radiologists, interventional cardiologists, and other vascular specialists presentations from world renowned vascular specialists with emphasis on the latest advances, changing concepts in diagnosis and management, pressing controversies and new techniques. The Veith symposium is sponsored by the Cleveland Clinic (Cleveland, OH, USA).

The researchers reported, however, that larger prospective randomized studies are needed to validate that earlier recanalization is superior to standard pharmacologic thrombolysis for the treatment of these disorders.

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Emory University School of Medicine