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News Room: In Touch: National study seeks to find best treatment for DVT

NIH-sponsored trial seeking patients with acute deep vein thrombosis

To download a pdf of this article, please click here.

Between 25 and 50 percent of all patients who suffer from lower-extremity deep vein thrombosis, or DVT, develop a chronic condition known as post-thrombotic syndrome (PTS). This syndrome typically causes daily pain, heaviness, fatigue and/or swelling of the affected leg. And, in more severe cases, patients can develop skin color changes, walking difficulties and ulcers that ultimately leave them unable to work or carry out daily activities. In short, their overall quality of life is significantly diminished.

The most common treatment for DVT is anticoagulants, including warfarin and Xarelto, for example. However, since these blood thinners do not directly dissolve the blood clot, it often remains in the vein and continues to block blood flow, causing permanent damage to the vein. This condition then leads to post-thrombotic syndrome.

Another treatment for DVT is pharmaco-mechanical catheter-directed thrombolysis (PCDT). With this treatment tissue plasminogen activator (tPA) is directly injected via catheter into the blood clot, actively dissolving the clot.

PCDT may thereby relieve DVT symptoms more quickly and prevent the vein damage that leads to PTS. Patients who undergo PCDT also receive anticoagulants before and after the treatment.

The Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter-Directed Thrombolysis, or ATTRACT Study is sponsored by the National Institutes of Health to determine whether removing blood clots using PCDT:
  • Safely prevents post-thrombotic syndrome.
  • Improves DVT patients’ quality of life.

In total, 692 patients in treatment for DVT nationally—including patients here at St. Elizabeth – will participate in this study. All patients will receive standard anticoagulant therapy, but half of them will be randomly selected to also undergo PCDT.

All patients will be fitted with compression stockings and will return for visits 10 days and one month after initial treatment. After 30 days, patients will undergo another ultrasound exam and will then be followed every six months for two years.

Study participation is voluntary and patients can withdraw at any time for any reason. Each patient receives a free pair of compression stockings at each visit, beginning at the first month follow-up.

The 30-day ultrasound and tPA (if the patient is randomized to the PCDT arm of the study) are free to patients. All participating patients are compensated for travel for each scheduled visit, except the10-day follow-up.

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