Dutch Randomized Trial Comparing Standard Catheter-Directed Thrombolysis and Ultrasound-Accelerated Thrombolysis for Arterial Thromboembolic Infrainguinal Disease (DUET)
| Autor: | Bram Fioole, A. Marjolein Schrijver, Michel M.P.J. Reijnen, Arjan W.J. Hoksbergen, Marc van Leersum, Anco C. Vahl, Jean-Paul P.M. de Vries |
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| Přispěvatelé: | Surgery, ICaR - Ischemia and repair |
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Mechanical Thrombolysis Ultrasonic Therapy medicine.medical_treatment Catheter directed thrombolysis Arterial Occlusive Diseases Axillofemoral Bypass Grafting Kaplan-Meier Estimate Disease law.invention Fibrinolytic Agents Randomized controlled trial Ischemia Risk Factors law Thromboembolism Catheterization Peripheral Occlusion medicine Humans Thrombolytic Therapy Radiology Nuclear Medicine and imaging Prospective Studies Hospitals Teaching Aged Netherlands Urokinase business.industry Ultrasound Thrombolysis Middle Aged medicine.disease Thrombosis Surgery Treatment Outcome Lower Extremity Female Radiology Cardiology and Cardiovascular Medicine business Follow-Up Studies medicine.drug |
| Zdroj: | de Schrijver, A, van Leersum, M, Fioole, B, Reijnen, M M, Hoksbergen, A W J, Vahl, A C & Vries, J P 2015, ' Dutch Randomized Trial Comparing Standard Catheter-Directed Thrombolysis and Ultrasound-Accelerated Thrombolysis for Arterial Thromboembolic Infrainguinal Disease (DUET) ', Journal of Endovascular Therapy, vol. 22, no. 1, pp. 87-95 . https://doi.org/10.1177/1526602814566578 Journal of Endovascular Therapy, 22(1), 87-95. International Society of Endovascular Specialists |
| ISSN: | 1526-6028 |
| Popis: | Purpose: To report the results of the Dutch randomized trial comparing standard catheter-directed and ultrasound-accelerated thrombolysis (UST) for the treatment of arterial thromboembolic occlusions. Methods: The DUET study ( controlled-trials.com ; identifier ISRCTN72676102) was designed to assess whether UST can reduce therapy time significantly compared with standard thrombolysis (ST). Sixty patients (44 men; mean age 64 years) with recently (7–49 days) thrombosed infrainguinal native arteries or bypass grafts causing acute limb ischemia (Rutherford category I or IIa) were randomized to ST (n=32) or UST (n=28). The primary outcome was the duration of thrombolysis needed for uninterrupted flow (>95% thrombus lysis), with outflow through at least 1 below-the-knee artery. Continuous data are presented as means ± standard deviations. Results: Thrombolysis was significantly faster in the UST group (17.7±2.0 hours) than in the ST group (29.5±3.2 hours, p=0.009) and required significantly fewer units of urokinase (2.8±1.6×106 IU in the ST group vs. 1.8±1.0×106 IU in the UST group, p=0.01) for uninterrupted flow. Technical success was achieved in 27 (84%) patients in the ST group vs. 21 (75%) patients in the UST group (p=0.52). The combined 30-day death and severe adverse event rate was 19% in the ST group and 29% in the UST group (p=0.54). The 30-day patency rate was 82% in the ST group as compared with 71% in the UST group (p=0.35). Conclusion: Thrombolysis time was significantly reduced by UST as compared with ST in patients with recently thrombosed infrainguinal native arteries or bypass grafts. |
| Databáze: | OpenAIRE |
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