Early results of thrombolysis vs anticoagulation in iliofemoral venous thrombosis. A randomised clinical trial

Objective: catheter directed thrombolysis has been advocated for complete and rapid dissolution of iliofemoral deep venous thrombosis (DVT). The aim of our study is to compare, in a randomised trial, local thrombolysis and anticoagulation with anticoagulation alone in patients with iliofemoral DVT. Methods: a consecutive series of 35 eligible patients, were randomised to either catheter directed thrombolysis followed by anticoagulation or to anticoagulation alone. Clot lysis and deep venous reflux were assessed with ultrasound duplex and plethysmography after 6 months. Results: complete data were available in the 18 and 17 patients randomised to thrombolysis and anticoagulation, respectively. At 6 months, patency rate was better in cases treated with, thrombolysis [13/18 (72%) vs 2/17 (12%), p < 0.001]. Venous reflux was higher in-patients treated with anticoagulant [7 patients (41%) vs 2 (11%), p = 0.04]. Conclusion: in the short-term patients treated with catheter directed thrombolysis obtained better patency and competence than those treated with standard anticoagulation.