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Study Casts Doubt on Costly Treatment for Leg Clots
Date:7/22/2014

ic syndrome.

"However, none of these studies have been definitive," Fonarow said. "Guideline recommendations regarding catheter-delivered thrombolysis are mixed, and use in clinical practice is modest and varies substantially by hospital," he added.

For the new study, published online July 21 in JAMA Internal Medicine, Bashir's team collected data on more than 90,600 patients hospitalized for deep vein thrombosis from 2005 through 2010.

About 4 percent of these patients underwent catheter-directed thrombolysis and also received blood-thinning drugs, the researchers found.

Over the study period, use of the catheter procedure more than doubled -- increasing from a little more than 2 percent in 2005 to nearly 6 percent in 2010, the study authors said.

Catheter-directed thrombolysis is an invasive treatment, and it's a potentially expensive one: $85,094 for the average hospital stay compared to $28,164 for patients given the anti-clotting medication and compression stockings, the researchers said.

Bashir's group found no significant difference in deaths between the treatments -- 1.2 percent for catheter-directed thrombolysis versus 0.9 percent for blood-thinning drugs.

But more complications were seen among patients who had catheter-directed thrombolysis. These included the need for blood transfusions, clots traveling to the lungs and bleeding in the brain. There was also a greater need for so-called vena cava filter placement -- placement of a filter to trap blood clots in the large vein that brings blood to the heart.

Patients who underwent catheter-directed thrombolysis also stayed in the hospital longer than those treated with anti-clotting drugs -- 7.2 days versus 5 days, according to the study.

Doctors should offer both treatment options to patients and explain the increased bleeding risks associated with catheter-directed thrombolysis on the one hand, and the increased risk of post-thrombotic syndro
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