Safety and efficacy of catheter directed thrombolytic therapy for lower extremity deep venous thrombosis:an umbrella review

doi:10.3877/cma.j.issn.2095-5782.2024.01.010

Abstract

Abstract:

Objective

To evaluate the systematic evaluation of the safety and efficacy of catheter directed thrombolysis in patients with lower extremity deep venous thrombosis.

Methods

In September 2021, systematic reviews/meta-analyses were retrieved from CNKI, WanFang Medical Platform, Web of Science, EBSCO, Cochrane Library, PubMed, Databases@OVID and other databases. The search strategy is a combination of Chinese/English free words and subject words and the Zotero software was used to manage references. Two researchers used AMSTAR2 and GRADE respectively to evaluate the quality of literature and outcome indicators.

Results

A total of 8 RCT/NRSI systematic evaluations were included. The evaluation results of AMSTAR2 showed that 1 article was of high quality, 1 article was of intermediate quality,3 articles were of low quality and 3 articles were of extremely low quality. GRADE evaluation results showed 0 advanced evidences, accounting for 0%; 7 pieces of intermediate evidence, accounting for 23.33%,16 pieces of low-level evidence, accounting for 53.33%, and 7 pieces of extremely low-level evidence, accounting for 23.33%.

Conclusion

The infusion method, time and dose of thrombolytic drugs are the influencing factors of bleeding related safety. The main evidence of effectiveness was the rate of venous patency and the incidence of post-thrombotic syndrome. However, the relevant evidence is limited, which still needs further study.

Key words: Deep vein thrombosis, Catheter directed thrombosis, Safety, Efficacy, Umbrella review

Yong Wang, Li Wang. Safety and efficacy of catheter directed thrombolytic therapy for lower extremity deep venous thrombosis:an umbrella review[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2024, 12(01): 58-63.

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References 34

[1]	Alesh I, Kayali F, Stein PD. Catheter-directed thrombolysis (intrathrombus injection) in treatment of deep venous thrombosis: a systematic review[J]. Catheter Cardiovasc Interv, 2007, 70(1): 143-148.
[2]	Ng TT, Sigman M, Weaver FA. Basic data related to thrombolytic therapy for acute venous thrombosis[J]. Ann Vasc Surg, 2014, 28(4): 1039-1044.
[3]	Enden T, Haig Y, Kløw NE, et al. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial[J]. Lancet, 2012, 379(9810): 31-38.
[4]	Alhazmi L, Moustafa A, Mangi MA, et al. Efficacy and safety of catheter-directed thrombolysis in preventing post-thrombotic syndrome: a meta-analysis[J]. Cureus, 2019, 11(2): e4152.
[5]	Wang L, Zhang C, Mu S, et al. Safety of catheter-directed thrombolysis for the treatment of acute lower extremity deep vein thrombosis: a systematic review and meta-analysis[J]. Medicine (Baltimore), 2017, 96(35): e7922.
[6]	Comerota AJ, Kearon C, Gu CS, et al. Endovascular thrombus removal for acute iliofemoral deep vein thrombosis[J]. Circulation, 2019, 139(9): 1162-1173.
[7]	Casey ET, Murad MH, Zumaeta-Garcia M, et al. Treatment of acute iliofemoral deep vein thrombosis[J]. J Vasc Surg, 2012, 55(5): 1463-1473.
[8]	Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both[J].BMJ, 2017, 358: j4008.
[9]	葛龙, 潘蓓, 潘佳雪, 等. 解读AMSTAR-2——基于随机和(或)非随机对照试验系统评价的质量评价工具[J].中国药物评价, 2017, 34(5): 334-338.
[10]	张方圆, 沈傲梅, 曾宪涛, 等. 系统评价方法学质量评价工具AMSTAR 2解读[J]. 中国循证心血管医学杂志, 2018, 10(1): 14-18.
[11]	倪萍, 时景璞. 系统评价与Meta分析再评价方法的更新及展望[J]. 中国循证心血管医学杂志, 2018, 10(10): 1170-1174.
[12]	Sterne JA, Hernan MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions[J]. BMJ, 2016, 355: i4919.
[13]	曾宪涛, 冷卫东, 李胜, 等. 如何正确理解及使用GRADE系统[J]. 中国循证医学杂志, 2011, 11(9): 985-990.
[14]	王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, (11): 964-967.
[15]	Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendation[J]. BMJ, 2008, 336(7650): 924-926.
[16]	陈耀龙, 姚亮, Norris Susan, 等. GRADE在系统评价中应用的必要性及注意事项[J]. 中国循证医学杂志, 2013, 13(12): 1401-1404.
[17]	邓通, 汪洋, 王云云, 等. 临床实践指南制订方法——GRADEproGDT在干预性系统评价证据分级中的应用[J]. 中国循证心血管医学杂志, 2019, 11(1): 1-5.
[18]	Balshem H, Helfand M, Schünemann HJ, et al. GRADE guidelines: 3.Rating the quality of evidence[J]. J Clin Epidemiol, 2011, 64(4): 401-406.
[19]	朱文莉. 中医护理适宜技术干预糖尿病足的文献计量分析和系统评价再评价[D]. 合肥: 安徽中医药大学, 2020.
[20]	刘辉, 承文龙, 卢辉俊. 导管溶栓与系统溶栓治疗急性下肢深静脉血栓形成的Meta分析[J]. 中国血管外科杂志(电子版), 2016, 8(3): 183-187.
[21]	朱远志. 导管溶栓治疗早期髂股静脉血栓形成的疗效及安全性系统评价[D]. 乌鲁木齐: 新疆医科大学, 2011.
[22]	徐一丁, 胡波, 仲斌演, 等. AngioJet机械吸栓联合导管接触溶栓与单纯导管接触溶栓治疗急性下肢深静脉血栓形成的Meta分析[J]. 介入放射学杂志, 2020, 29(9): 888-893.
[23]	Farrokhi M, Khurshid M, Mohammadi S, et al. Comparison of ultrasound-accelerated versus conventional catheter-directed thrombolysis for deep vein thrombosis: a systematic review and meta-analysis[J]. Vascular, 2022, 30(2): 365-374.
[24]	Xing Z, Tang L, Zhu Z, et al. Effects of thrombolysis on outcomes of patients with deep venous thrombosis: an updated meta-analysis[J]. PLoS One, 2018, 13(9): e0204594.
[25]	Tang T, Chen L, Chen J, et al. Pharmacomechanical thrombectomy versus catheter-directed thrombolysis for iliofemoral deep vein thrombosis: a meta-analysis of clinical trials[J]. Clin Appl Thromb Hemost, 2019, 25: 1076029618821190.
[26]	Watson L, Broderick C, Armon MP. Thrombolysis for acute deep vein thrombosis[J]. Cochrane Database Syst Rev, 2016, 11(11): CD002783.
[27]	Broderick C, Watson L, Armon MP. Thrombolytic strategies versus standard anticoagulation for acute deep vein thrombosis of the lower limb[J]. Cochrane Database Syst Rev, 2021, 1(1): CD002783.
[28]	Liew A, Douketis J. Catheter-directed thrombolysis for extensive iliofemoral deep vein thrombosis: review of literature and ongoing trials[J]. Expert Rev Cardiovasc Ther, 2016, 14(2): 189-200.
[29]	Birhan A, Assefa T, Beyene A, et al. Outcome of acute deep venous thrombosis using standard treatment versus thrombolytics: a literature review[J]. Int J Hematol Oncol Stem Cell Res, 2019, 13(4): 201-207.
[30]	Elbasty A, Metcalf J. Safety and efficacy of catheter direct thrombolysis in management of acute iliofemoral deep vein thrombosis: a systematic review[J]. Vasc Specialist Int, 2017, 33(4): 121-134.
[31]	Siddiqui NA, Moosa MA, Shaikh FA, et al. Predictors of poor quality of life after primary lower limb deep venous thrombosis: a perspective from a developing nation[J]. Ann Vasc Dis, 202, 13(1): 63-68.
[32]	Hu G, Wang J. Percutaneous endovenous intervention versus anticoagulation in the treatment of lower extremity deep vein thrombosis: a systematic review and meta-analysis[J]. Ann Transl Med, 2022, 10(18): 1018.
[33]	Goldhaber SZ, Magnuson EA, Chinnakondepalli KM, et al. Catheter-directed thrombolysis for deep vein thrombosis: 2021 update[J]. Vasc Med, 2021, 26(6): 662-669.
[34]	杨克虎, 刘雅莉, 袁金秋, 等. 发展和完善中的系统评价再评价[J]. 中国循证儿科杂志, 2011, 6(1): 54-57.

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