Ultrasound-accelerated thrombolysis is more effective for DVT lysis than standard thrombolysis alone, a small US study has suggested.

"Ultrasound-accelerated thrombolysis is more effective for DVT lysis than thrombolysis alone, a small US study has suggested [1].

This relatively new technique involves the delivery of low-intensity ultrasound energy alongside thrombolytic agent delivery into the occluded vessel.

The study authors evaluated the clinical outcomes of ultrasound-accelerated thrombolysis in 47 patients with 53 cases of DVT, including lower and upper extremity and hepatic locations.

They reported partial lysis in 91 per cent, with complete lysis of the occlusion in seven out of ten patients. Major complications were seen in just two patients who developed a hematoma at the site of earlier surgery.

The group concluded: "The present study demonstrates a considerable improvement versus previous studies of catheter-directed thrombolysis alone for the treatment of DVT, with fewer complications, reduced drug doses, and shorter infusion times.

Costs were likely to be lower than standard thrombolysis owing to reduced drug doses and a shorter intensive care unit stay, the researchers added.

Dr Sanjiv Parikh, of the Department of Interventional Radiology at the Swedish Medical Center in Seattle and one of the study authors, said: "Ultrasound accelerated thrombolysis does a better job in clearing thrombus completely. This has relevance as it reduces the chance of valvular incompetence and thereby post-thrombotic syndrome, which can present in many ways as delayed clinical sequalae.

"This technique has the potential to perform better than standard infusion catheter technique because of better penetration of the drug into the clot interstices and therefore more surface contact of the drug with the clot."

However, Dr Gerard O'Sullivan, an interventional radiologist at University College Hospital in Galway, Ireland, noted: "Ultrasound accelerated thrombolysis makes sense in that it shortens the time for treatment of DVTs but it is not a single session treatment, so patients still require an HDU bed, in-patient care and so on."

He added: "Pharmaco-mechanical thrombectomy is shorter and probably cheaper in terms of hospital costs"


[1] Ultrasound-accelerated thrombolysis for the treatment of deep vein thrombosis: Initial clinical experience
J Vasc Interv Radiol 2008;19:521–528"

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