Catheter Procedure for Blood Clots May Pose Risks

Cardiovascular treatment of blood clots with catheters led to more complications

(RxWiki News) Doctors are increasingly using a catheter-based procedure to guide medication to treat blood clots. While the approach has been shown to save lives, it may also raise certain health risks.

In catheter-directed thrombolysis (CDT), doctors use X-ray imaging to guide medication or a medical device to the site of a blockage in a blood vessel. Although the procedure may help people live longer, it may also lead to postthrombotic syndrome complications, which may include pain, swelling, heaviness and ulcerations (open sores on the skin).

Scientists recently found that patients using anticoagulants (blood thinners) alone compared to CDT and anticoagulants may have similar death rates but fewer safety concerns.

"Learn the risks associated with your blood clot treatment."

Riyaz Bashir, MD, a cardiologist with the Temple University School of Medicine in Philadelphia, and colleagues reviewed records of 90,618 patients hospitalized from 2005 through 2010 with deep vein thrombosis. Deep vein thrombosis occurs when a clot forms in a vein deep inside the body.

Of these individuals, 3,649 (4.1 percent) underwent CDT. Compared to those who only received anticoagulants, the death rate in the CDT patients was about the same — 1.2 percent for the CDT group versus 0.9 percent for anticoagulant patients.

Rates of adverse events, however, were greater among the CDT patients. The researchers reported that these patients had a greater percentage of blood transfusions (11.1 percent versus 6.5 percent); pulmonary embolisms, or blocked arteries in the lungs (17.9 percent versus 11.4 percent); intracranial hemorrhages, or bleeding within the skull (0.9 percent versus 0.3 percent); and placements of vena cava filters, or devices designed to prevent blood clots from traveling to the lungs (34.8 percent versus 15.6 percent).

Although more research is needed, the authors concluded that “it may be reasonable to restrict this form of [CDT] therapy to those patients who have a low bleeding risk and a high risk for [postthrombotic syndrome]."

The authors of this study noted that CDT use was on the rise, climbing from 2.3 percent of patients in 2005 to 5.9 percent in 2010. Compared to individuals receiving only anticoagulants, however, CDT patients had longer hospital stays (7.2 versus 5 days) and higher hospital charges ($85,094 versus $28,164) on average.

This study was published online July 21 in JAMA Internal Medicine. Contributing authors reported receiving support from Covidien, Health Systems Networks and Insight Telehealth.

Review Date: 
July 21, 2014