Effectiveness And Safety Of Catheter-directed Thrombolysis Versus Anticoagulation For Iliofemoral Venous Thrombosis: A Systematic Review And Meta-analyses Of Randomized Controlled Trials.

Objective:To evaluate the efficacy and safety of catheter-directed thrombolysis (CDT) compared with traditional treatment (Anticoagulant alone AC) for early (pristine) IFVT. Methods:We have searched MEDLINE (OVID,1990 to June 2010), EMBASE (1990 to June 2010), Cochrane Central Register of Controlled Trials (1991 to June 2010), PubMed (1990 to June 2010), Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal, Full-text Database (CSJD), and Chinese Journal Full-text Database (CJFD), added with handsearching and other retrievals. The Cochrane Collaboration's RevMan 5.0.18 was used for meta-analyses. Results:Only two randomized controlled trials are available currently that were included in the study. Meta-analyses showed that 6 months after treatment, iliofemoral vein patency rate of CDT group was higher than that of AC group[45/68 vs 21/70, OR=4.47,95%CI (2.19,9.12), P<0.0001], the iliofemoral vein occlusionand (or) venous reflux rate of CDT group was less than that of AC group [12/68 vs 33/70, OR=0.24,95%CI (0.11,0.53), P=0.0004]. Major complications, CDT group and AC group was not statistically significant [2/68 vs 1/70, OR=1.53,95%CI (0.25,9.24), P=0.65] But the minor complications and total complications of CDT group were higher than that of AC group, [11/68 vs 2/70,OR=5.48,95%CI (1.33,22.51), P=0.02] and [13/68 vs 3/70, OR=3.55,95%CI (1.20,10.45), P=0.02]. Conclusions CDT is an positively effective way to treat early IFVT, The implementation of CDT to the patients without contraindications can get good therapeutic effect.