Table 32:
Duration of Thrombolytic Infusion With Mechanical Thrombectomy Use in Acute and Subacute DVT in Observational Studies
| Results | ||||
|---|---|---|---|---|
| Author, year | Outcome measurementa | MT | Comparator | P value |
| PMT (AngioJet) | ||||
| Garcia et al, 201585 | Mean procedure time | PMT: 2 h PMT + CDT: 22 h | RT alone: 1.4 h RT + CDT: 41 h | P < .0001 |
| Procedures completed in less than 24 h | 73% | NR | NA | |
| Average run time with AngioJet | 7.2 min (SD ± 6.3) | NA | NA | |
| Huang et al, 202197 | Mean time of thrombolytic | 1.42 d (SD ± 0.32) | 4.20 d (SD ± 1.25) | P = .000 |
| Lee et al, 202099 | Duration of thrombolysis | 27.1 h (SD ± 16.5) | 35.3 (SD ± 18.2) | P = .018 |
| Li et al, 2020100 | Operation procedure time | 101.6 min (SD ± 47.2) | 121.3 min (SD ± 17.6) | P = .002 |
| Pouncey et al, 2020103 | Lysis duration | PCDT: 41.5 h (95% CI: 25-47) AngioJet PowerPulse: 24.5 h (95% CI: 20-29) | 48.0 h (95% CI: 47-61) | P < .001 |
| Tian et al, 2021105 | Mean treatment duration | 0.97 h (SD ± 0.20) | 32.48 h (SD ± 7.46) | P < .0001 |
| Xu et al, 2020108 | Among those with Grade III,b time of treatment | 2.2 d (SD ± 5.8) | 3.1 d (SD ± 0.8) | P = .01 |
| Zhu et al, 2020109 | Time of thrombolysis | 4.2 h (SD ± 1.7) | 73.6 h (SD ± 18.3) | P = .0 |
| Vacuum Aspiration (Indigo) | ||||
| No studies met our inclusion criteria for this MT device | ||||
| Rotational (Rotarex or Cleaner) | ||||
| We did not identify any observational studies that reported on this outcome of interest | ||||
| Ultrasound Assisted (EKOS) | ||||
| Baker et al, 201294 | Mean overall infusion time | 27 h (IQR: 21 − 27) | 25 h (IQR: 22 − 39) | P = .39 |
| Lu et al, 201775 | Mean lysis time | 21 h (SD ± 1.7) | 24 (SD ± 1.8) | P = .26 |
| Tichelaar et al, 2016106 | Proportion who had a duration of intervention < 48 hc | 27% (n = 9) | 10% (n = 6) | P < .005 |
Abbreviations: CI, confidence interval; DVT, deep vein thrombosis; IQR, interquartile range; MT, mechanical thrombectomy; NA, not applicable; NR, not reported; PCDT, pharmacomechanical catheter-directed thrombolysis; PMT, pharmacomechanical thrombectomy; RT, rheolytic thrombectomy; SD, standard deviation.
Urokinase dose unit of measurement was inconsistent across the studies; however, this did not inhibit our analysis as the findings of interest are relative dose differences between study groups within any individual study.
Findings were similar for those with Grade II, but not significantly differently among those patients with Grade I.
Other timeframes up to 120 hours were not significantly different between study groups.