Deep vein thrombosis invasive therapy: Difference between revisions
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Rim Halaby (talk | contribs) /* 2011 AHA Scientific Statement-Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension (DO NOT EDIT){{cite journal|author=Jaff MR, McMurtry MS, Archer SL, Cushman M,... |
Rim Halaby (talk | contribs) /* Recommendations for Endovascular Thrombolysis and Surgical Venous Thrombectomy (DO NOT EDIT){{cite journal|author=Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ et al.| title=Management of massive and submassive pulmonary emb... |
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' CDT or PCDT is reasonable as first-line treatment of patients with acute IFDVT to prevent PTS in selected patients at low risk of bleeding complications ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''.<nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' CDT or PCDT is reasonable as first-line treatment of patients with acute IFDVT to prevent PTS in selected patients at low risk of bleeding complications ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''.<nowiki>"</nowiki> | ||
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===Recommendations for Percutaneous Transluminal Venous Angioplasty and Stenting (DO NOT EDIT)<ref name="pmid21422387">{{cite journal|author=Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ et al.| title=Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. | journal=Circulation | year= 2011 | volume= 123 | issue= 16 | pages= 1788-830 |pmid=21422387 | doi=10.1161/CIR.0b013e318214914f| pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21422387 }} </ref>=== | |||
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| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | |||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Stent placement in the iliac vein to treat obstructive lesions after CDT, PCDT, or surgical venous thrombectomy is reasonable ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''.<nowiki>"</nowiki> | |||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' For isolated obstructive lesions in the common femoral vein, a trial of percutaneous transluminal angioplasty without stenting is reasonable ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''.<nowiki>"</nowiki> | |||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' The placement of iliac vein stents to reduce PTS symptoms and heal venous ulcers in patients with advanced PTS and iliac vein obstruction is reasonable ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.''' After venous stent placement, the use of therapeutic anticoagulation with similar dosing, monitoring, and duration as for IFDVT patients without stents is reasonable ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
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{|class="wikitable" | |||
|- | |||
| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | |||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' After venous stent placement, the use of antiplatelet therapy with concomitant anticoagulation in patients perceived to be at high risk of rethrombosis may be considered ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |||
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Revision as of 15:42, 12 July 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
2011 AHA Scientific Statement-Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension (DO NOT EDIT)[1]
Recommendations for Endovascular Thrombolysis and Surgical Venous Thrombectomy (DO NOT EDIT)[1]
| Class I |
| "1. CDT or PCDT should be given to patients with IFDVT associated with limb-threatening circulatory compromise (ie, phlegmasia cerulea dolens) (Level of Evidence: C)." |
| "2. Patients with IFDVT at centers that lack endovascular thrombolysis should be considered for transfer to a center with this expertise if indications for endovascular thrombolysis are present (Level of Evidence: C)." |
| Class III (No Benefit) |
| "1. Systemic fibrinolysis should not be given routinely to patients with IFDVT (Level of Evidence: A)." |
| "2. CDT or PCDT should not be given to most patients with chronic DVT symptoms (>21 days) or patients who are at high risk for bleeding complications (Level of Evidence: B)." |
| Class IIa |
| "1. CDT or PCDT is reasonable for patients with IFDVT associated with rapid thrombus extension despite anticoagulation (Level of Evidence: C) and/or symptomatic deterioration from the IFDVT despite anticoagulation (Level of Evidence: B)." |
| "2. CDT or PCDT is reasonable as first-line treatment of patients with acute IFDVT to prevent PTS in selected patients at low risk of bleeding complications (Level of Evidence: B)." |
Recommendations for Percutaneous Transluminal Venous Angioplasty and Stenting (DO NOT EDIT)[1]
| Class IIa |
| "1. Stent placement in the iliac vein to treat obstructive lesions after CDT, PCDT, or surgical venous thrombectomy is reasonable (Level of Evidence: C)." |
| "2. For isolated obstructive lesions in the common femoral vein, a trial of percutaneous transluminal angioplasty without stenting is reasonable (Level of Evidence: C)." |
| "3. The placement of iliac vein stents to reduce PTS symptoms and heal venous ulcers in patients with advanced PTS and iliac vein obstruction is reasonable (Level of Evidence: C)" |
| "4. After venous stent placement, the use of therapeutic anticoagulation with similar dosing, monitoring, and duration as for IFDVT patients without stents is reasonable (Level of Evidence: C)" |
| Class IIb |
| "1. After venous stent placement, the use of antiplatelet therapy with concomitant anticoagulation in patients perceived to be at high risk of rethrombosis may be considered (Level of Evidence: C) " |
References
- ↑ 1.0 1.1 1.2 Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ; et al. (2011). "Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association". Circulation. 123 (16): 1788–830. doi:10.1161/CIR.0b013e318214914f. PMID 21422387.