Comparison of ultrasound-accelerated versus conventional catheter-directed thrombolysis for deep vein thrombosis: A systematic review and meta-analysis. (April 2022)

• Record Type: Journal Article
• Authors: Farrokhi, Mehrdad; Khurshid, Maria; Mohammadi, Sassan; Yarmohammadi, Bardia; Bahramvand, Yaser; Nasrollahi, Elham; Taheri, Fatemeh
• Is Part Of: Vascular. Volume 30:Number 2(2022)
• Page Start: 365
• Page End: 374
• Publication Date: 2022-04
• Subjects: Catheter-directed thrombolysis -- ultrasound-accelerated thrombolysis -- deep vein thrombosis -- meta-analysis -- systematic review; 616.13
• DOI: 10.1177/17085381211010532
• Languages: English
• ISSNs: 1708-5381

Abstract

Background: Recent in vitro and clinical studies have shown that ultrasound-accelerated catheter-directed thrombolysis (USACDT) can accelerate thrombolysis. Therefore, in this meta-analysis, we aimed to compare the efficacy and safety of USACDT with conventional catheter-directed thrombolysis in patients with deep vein thrombosis. Methods: A systematic search of the following electronic databases was performed from their dates of inception to 20 June 2020: MEDLINE, Scopus, Google Scholar, CINAHL, Cochrane Library, and EMBASE. All randomized controlled trials that directly compared the complications and efficacy of USACDT and conventional catheter-directed thrombolysis in patients with deep vein thrombosis were identified. The statistical analysis was performed using comprehensive meta-analysis software. Results: Finally, 18 studies with a total of 597 participants were included in our meta-analysis according to the eligibility criteria. Pooled proportion of USACDT success in patients with deep vein thrombosis was 87.8% (18 studies; 95% CI: 83.1–91.3). Success rate was significantly higher in USACDT treatment than in conventional catheter-directed thrombolysis treatment (seven studies; OR: 2.96; 95% CI: 1.69–5.16; P < 0.01)). Although the mean infusion time was higher in catheter-directed thrombolysis treatment compared to USACDT treatment, this difference was not statistically significant (three studies; MD: –1.46; 95% CI: –3.25–0.32; P = 0.10). Moreover, pooled rate of complications was lower in USACDT than catheter-directed thrombolysis which was not statistically significant (seven studies; OR: 0.49; 95% CI: 0.13–1.76; P = 0.27). Conclusion: This meta-analysis revealed that USACDT significantly increased the success rate of thrombolysis compared to conventional catheter-directed thrombolysis. Furthermore, USACDT was associated with lower rate of complication and infusion time. Taken together, these findings confirm the superiority of this novel intervention over conventional catheter-directed thrombolysis in treatment of patients with deep vein thrombosis.