Sex-based differences in utilization and outcomes for catheter-directed thrombolysis

March 20, 2017

Deep vein thrombosis (DVT) is a serious condition that occurs when a blood clot forms in a vein, often in the deep veins of the legs, thigh or pelvis. Those clots can break loose, travel to the lungs and block blood flow, causing a pulmonary embolism.

The majority of with DVT develop it in their lower extremities and that leads to a painful condition known as post-thrombotic syndrome in approximately half of all patients. Post-thrombotic syndrome is marked by pain, swelling, redness and chronic sores in the affected legs. Patients can also develop DVT in a vein carrying deoxygenated blood to the heart from the lower body or from the head, arms and upper body. This is called caval DVT.

One way to treat DVT is a procedure called catheter-directed thrombolysis (CDT), which allows physicians to place a clot-dissolving agent directly into the clot. CDT has become more commonly used in the United States since research showed it reduced the incidence of post-thrombotic syndrome.

Given this increased utilization, a research team led by Riyaz Bashir, MD, FACC, RVT, Professor of Medicine at the Lewis Katz School of Medicine at Temple University and Director of Vascular and Endovascular Medicine at Temple University Hospital, sought to identify and describe sex-based differences in utilization and safety outcomes of CDT for treatment of DVT in the U.S. In research published online by the journal Vascular Medicine, the team found sex-based differences in both utilization and safety outcomes.

"The data provided some interesting findings," says Dr. Bashir. "In addition to differences in utilization, we were able to find variations in the incidence of a number of complications, including bleeding that requires blood transfusion, , gastrointestinal bleeding and , as well as the incidence of angioplasty, stenting, and adjunctive IVC filter placement."

The research team used the Nationwide Inpatient Sample database to identify 108,243 patients age 18 years or older with a primary discharge diagnosis of proximal lower extremity or caval DVT between January 2005 and December 2011. Of those patients, 4,826 (4.5%) were treated with CDT.

Among the team's findings:

  • Female patients were less likely to be treated with CDT for DVT.
  • Female patients experienced more bleeding complications requiring blood transfusion.
  • Intracranial hemorrhage, and acute kidney injury were more common in male patients.
  • Mortality rates were similar for both men and women treated with CDT.
  • Women treated with CDT were more likely to undergo angioplasty, stenting and adjunctive IVC filter placement.

"Future research should focus on uncovering why these sex-based differences exist," says Dr. Bashir. "The answers to those questions could help shape future treatment guidelines for patients who are suitable candidates for CDT."

Explore further: Study examines whether compression stockings can prevent post-thrombotic syndrome

Related Stories

Study examines whether compression stockings can prevent post-thrombotic syndrome

May 5, 2016
Deep vein thrombosis occurs when a blood clot forms in a vein, often in the deep veins of the legs, thigh or pelvis. Approximately half of people with this problem will develop post thrombotic syndrome—a condition marked ...

Temple-led research analyzes impact of case volume on outcomes for DVT treatment

July 24, 2015
Patients who have lower extremity proximal deep vein thrombosis (LE-DVT), or a blood clot in their leg, are increasingly undergoing minimally invasive catheter-based blood clot removal - also referred to as catheter-directed ...

Study compares deep vein thrombosis therapies (Update)

July 21, 2014
Patients who have a clot in their legs and are considering whether to be treated with traditional blood-thinning medication or undergo a minimally-invasive catheter-based clot removal procedure should feel comfortable that ...

Structure of kidney failure patients' blood clots may increase their risk of early death

January 5, 2017
Dialysis patients may have altered blood clots that increase their risk of dying prematurely, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN).

Serious complication of post-thrombotic syndrome often causes lengthy disability

March 4, 2014
Deep vein thrombosis (DVT) often brings with it the risk of post-thrombotic syndrome (PTS), an under-recognized but serious complication that often causes long-term disability for patients. During March's DVT Awareness Month, ...

Preventive therapy in brain-injured patients lowers risk of pulmonary embolism and DVT

July 21, 2016
People who sustain a traumatic brain injury (TBI) are at high risk for developing deep vein thrombosis (DVT) and pulmonary embolism (PE). PE is a leading cause of death in these patients. But blood-thinning medications started ...

Recommended for you

How genes and environment interact to raise risk of congenital heart defects

October 19, 2017
Infants of mothers with diabetes have a three- to five-fold increased risk of congenital heart defects. Such developmental defects are likely caused by a combination of genetic and environmental factors. However, the molecular ...

Mouse studies shed light on how protein controls heart failure

October 18, 2017
A new study on two specially bred strains of mice has illuminated how abnormal addition of the chemical phosphate to a specific heart muscle protein may sabotage the way the protein behaves in a cell, and may damage the way ...

Newborns with trisomy 13 or 18 benefit from heart surgery, study finds

October 18, 2017
Heart surgery significantly decreases in-hospital mortality among infants with either of two genetic disorders that cause severe physical and intellectual disabilities, according to a new study by a researcher at the Stanford ...

Saving hearts after heart attacks: Overexpression of a gene enhances repair of dead muscle

October 17, 2017
University of Alabama at Birmingham biomedical engineers report a significant advance in efforts to repair a damaged heart after a heart attack, using grafted heart-muscle cells to create a repair patch. The key was overexpressing ...

High blood pressure linked to common heart valve disorder

October 17, 2017
For the first time, a strong link has been established between high blood pressure and the most common heart valve disorder in high-income countries, by new research from The George Institute for Global Health at the University ...

Blood cancer gene could be key to preventing heart failure

October 16, 2017
A new study, published today in Circulation, shows that the gene Runx1 increases in damaged heart muscle after a heart attack. An international collaboration led by researchers from the University of Glasgow, found that mice ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.