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Phlebology ; 34(2): 115-127, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29788818


OBJECTIVES: The aim is to evaluate venous stent patency, the development of post-thrombotic syndrome, recurrence, quality of life and the optimal post-procedural anticoagulation regimen in the treatment of iliofemoral deep venous thrombosis. METHOD AND RESULTS: EMBASE and Medline databases were interrogated to identify studies in which acute deep venous thrombosis patients were stented. Twenty-seven studies and 542 patients were identified. Primary, assisted primary and secondary patency rates 12 months after stent placement ranged from 74 to 95, 90 to 95 and 84 to 100%, respectively. The observed post-thrombotic syndrome rate was 14.6%. The incidence of stent re-thrombosis was 8%. In 26% of studies, patients received additional antiplatelet therapy. Quality of life questionnaires employed in 11% of studies, demonstrating an improvement in the chronic venous insufficiency questionnaire (22.67 ± 3.01 versus 39.34 ± 6.66). CONCLUSION: Venous stenting appears to be an effective adjunct to early thrombus removal; however, further studies are needed to identify optimal anticoagulant regimen and effect on quality of life.

Extremidade Inferior/irrigação sanguínea , Trombólise Mecânica , Stents , Insuficiência Venosa/cirurgia , Trombose Venosa/cirurgia , Doença Aguda , Doença Crônica , Feminino , Humanos , Extremidade Inferior/cirurgia , Masculino , Insuficiência Venosa/fisiopatologia , Trombose Venosa/fisiopatologia
Phlebology ; 34(3): 179-190, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29860923


OBJECTIVES: The aim was to assess the effectiveness and safety of catheter-directed thrombolysis in children with deep venous thrombosis and to evaluate its long-term effect. METHOD AND RESULTS: EMBASE, Medline and Cochrane databases were searched to identify studies in which paediatric acute deep venous thrombosis patients received thrombolysis. Following title and abstract screening, seven cohort studies with a total of 183 patients were identified. Technical success was 82% and superior in regional rather than systemic thrombolysis (p < 0.00001). One cohort study identified significant difference in thrombus resolution at one year between thrombolytic and anticoagulant groups (p = 0.01). The complication rate was low, with incidence rates of major bleeding, pulmonary embolism and others at 2.8%, 1.8% and 8.4%, respectively. The overall post-thrombotic syndrome rate was 12.7%. The incidence of re-thrombosis ranged from 12.3% to 27%. CONCLUSION: Thrombolysis for paediatric deep venous thrombosis is an effective and relatively safe therapeutic option, lowering the incidence of post-thrombotic syndrome and deep venous thrombosis recurrence.

Anticoagulantes/uso terapêutico , Terapia Trombolítica/métodos , Trombose Venosa/tratamento farmacológico , Anticoagulantes/efeitos adversos , Criança , Feminino , Humanos , Masculino , Terapia Trombolítica/efeitos adversos , Trombose Venosa/sangue , Trombose Venosa/patologia