Catheter Delivered Treatment (CDT) for Deep Vein Thrombosis. A Multi-Centre Study of Current Practice

Steering Committee: N. Charlwood, C. Lowe, C. Goatman, J. Buxton, J. Packer, J. Ghosh

Aim

This study aimed to review practice in Catheter Delivered Treatment (CDT) for Deep Vein Thrombosis (DVT) across the North West of England.

Background

Post-thrombotic syndrome is the development of chronic venous insufficiency after DVT and occurs in more than 40% of proximal DVTs. It can have significant impact on Quality of Life with 6% developing severe symptoms and represents 75% of the cost of treating the DVT. NICE guidance recommends consideration of CDT for proximal DVT, with the aim of preventing post-thrombotic syndrome.

Methods

A retrospective review of case notes in four vascular units between March-April 2014 was performed looking at referral pathways, variation in practice & outcomes after CDT for DVT.

Results

Of 2560 cases of DVT identified, only 15 cases underwent CDT (0.58%). Patients were mostly females (11F:4M) with median age 43 years (16-64). Twelve patients underwent catheter thromboysis and 3 mechanical thrombectomy. Median treatment duration was 36 hours (range 1-9 6). IVC filter was deployed in 6 patients and venoplasty/stenting performed in six. Complete lysis was achieved in 13 patients. There were two bleeding complications; one minor, one major (managed conservatively). No patients had PE. Median inpatient stay was 7 days (range 5-23) and follow up range was 6-24 months. CDT was safe and effective though the number treated was lower than would be expected and significant variation in practice was noted between units. Vigilance should be heightening amongst admitting physicians to ensure that patients who would benefit from CDT are referred acutely to their regional vascular unit.

Output

An abstract was published in the European Journal of Vascular and Endovascular Surgery and presented or orally at the British Society of Endovascular Therapy Annual meeting 2015.

Catheter Delivered Treatment (CDT) for Deep Vein Thrombosis. A Multi-centre Study of Current PracticeCharlwood, N, Lowe, C. Goatman, J. Buxton, J. Packer, J. Ghosh. European Journal of Vascular and Endovascular Surgery , Volume 50 , Issue 3 , e16

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