Thrombolysis for DVT---new concerns raised

---in a recent presentation at the Vascular Annual Meeting as reported in Internal Medicine News. An analysis of patients treated between 1998 and 2003 showed an increase in CNS bleeding and in hospital mortality. One of the investigators, in an interview with Internal Medicine News, speculated that most of the patients received catheter delivered local thrombolysis rather than systemic thrombolysis although those numbers were not available for analysis.

Thrombolytic therapy for DVT, particularly catheter guided local thrombolysis, has become increasingly appealing as an option for prevention of post thrombotic syndrome though never considered standard of care. Local thrombolytic therapy, along with various catheter extraction techniques, has also garnered interest as a possible remedy for the desperate situation of venous gangrene (phlegmasia cerula dolens).

I previously reviewed the controversy here.