Clinical impact of assessing thrombus age using magnetic resonance venography prior to catheter-directed thrombolysis.
Magnetic resonance venography
Thrombolysis
Thrombosis
Thrombus
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
received:
29
07
2021
accepted:
19
01
2022
revised:
17
01
2022
pubmed:
30
3
2022
medline:
24
6
2022
entrez:
29
3
2022
Statut:
ppublish
Résumé
Magnetic resonance venography (MRV) is underutilized in the evaluation of thrombus properties prior to endovascular treatment but may improve procedural outcomes. We therefore investigated the clinical impact of using a dedicated MRV scoring system to assess thrombus characteristics prior to endovascular intervention for iliofemoral deep vein thrombosis (DVT). This is a post hoc analysis of data from the CAVA trial ( Clinicaltrials.gov :NCT00970619). MRV studies of patients receiving ultrasound-accelerated catheter-directed thrombolysis (CDT) for iliofemoral DVT were reviewed. Thrombus age-related imaging characteristics were scored and translated into an overall score (acute, subacute, or old). MRV scores were compared to patient-reported complaints. MRV-scored groups were compared for CDT duration and success rate. Fifty-six patients (29 men; age 50.8 ± 16.4 years) were included. Using MRV, 27 thrombi were classified acute, 17 subacute, and 12 old. Based on patient-reported complaints, 11 (91.7%) of these old thrombi would have been categorized acute or subacute, and one (3.7%) of the acute thrombi as old. Average duration of CDT to > 90% restored patency differed significantly between groups (p < 0.0001): average duration was 23 h for acute thromboses (range: 19-25), 43 h for subacute (range: 41-62), and 85 h for old thromboses (range: 74-96). CDT was almost eleven times more successful in thromboses characterized as acute and subacute compared to old thromboses (OR: 10.7; 95% CI 2.1-55.5). A dedicated MRV scoring system can safely discriminate between acute, subacute, and old thromboses. MRV-based selection is predictive of procedural duration and success rate and can help avoid unnecessary complications. • Thrombus age, characterized by MRV as acute, subacute, and old, can predict CDT duration and probability of success. • Accurate pre-interventional MRV-based thrombus aging has the potential to facilitate identification of eligible patients and may thus prevent CDT-related complications.
Identifiants
pubmed: 35347362
doi: 10.1007/s00330-022-08599-5
pii: 10.1007/s00330-022-08599-5
pmc: PMC9213279
doi:
Banques de données
ClinicalTrials.gov
['NCT00970619']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4555-4564Subventions
Organisme : zonmw: the dutch organization for health research and development
ID : 171101001
Organisme : btg-interventional medicine
ID : n/a
Organisme : maastricht universitair medisch centrum
ID : n/a
Informations de copyright
© 2022. The Author(s).
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