| 1. Grosse SD, Nelson RE, Nyarko KA, Richardson LC, Raskob GE. The economic burden of incident venous thromboembolism in the United States: A review of estimated attributable healthcare costs. [Review]. Thrombosis Research. 137:3-10, 2016 Jan. |
Meta-analysis |
3 Studies |
To summarize estimates of per-patient and aggregate medical costs or expenditures attributable to incident VTE in the United States. |
Based on the studies identified, treatment of an acute VTE on average appears to be associated with incremental direct medical costs of $12,000 to $15,000 (2014 US dollars) among first-year survivors, controlling for risk factors. Subsequent complications are conservatively estimated to increase cumulative costs to $18,000-23,000 per incident case. Annual incident VTE events conservatively cost the US healthcare system $7-10 billion each year for 375,000 to 425,000 newly diagnosed, medically treated incident VTE cases. |
Good |
| 2. Sudheendra D, Vedantham S. Catheter-Directed Therapy Options for Iliofemoral Venous Thrombosis. [Review]. Surgical Clinics of North America. 98(2):255-265, 2018 Apr. |
Review/Other-Dx |
N/A |
To review catheter-directed thrombolysis options for iliofemoral DVT and discuss the risks, benefits, and techniques commonly used in performing endovascular procedures for iliofemoral DVT. |
One rigorously conducted randomized controlled trial has shown improved thrombus reduction and reduced rates of PTS following CDT for proximal DVT. In the CaVenT trial, a 14.4% absolute reduction in PTS rate was seen in patients with iliac or femoral treated with infusion CDT compared with patients receiving anticoagulation alone at 24-month follow-up (41% vs 56%, P = .047).15, 17, 25 However, there was no difference in 2-year health-related quality of life. Questions about the applicability of the CaVenT study to US practice relate to its small-medium size, lack of use of mechanical thrombectomy devices, and its performance in a geographically limited area (Southern Norway). The BERNUTIFUL (BERN Ultrasound-enhanced Thrombolysis for Iliofemoral Deep Vein Thrombolysis) trial compared US-assisted CDT (Ekowave catheter, EKOS Corporation, Bothell, WA, USA) for iliofemoral DVT versus standard CDT. However, no significant difference in important clinical outcomes, including thrombus load reduction and PTS, was found between the US-assisted CDT and conventional CDT groups |
4 |
| 3. Haig Y, Enden T, Grotta O, et al. Post-thrombotic syndrome after catheter-directed thrombolysis for deep vein thrombosis (CaVenT): 5-year follow-up results of an open-label, randomised controlled trial. The Lancet Haematology. 3(2):e64-71, 2016 Feb. |
Experimental-Tx |
209 patients |
To evaluate whether the previously shown clinical benefit of catheter-directed thrombolysis was sustained for 5 years and whether quality of life was affected. |
At 5 year follow-up (last date Oct 14, 2014), data were available for 176 patients (84% of the 209 patients originally randomised)—87 originally assigned to catheter-directed thrombolysis and 89 originally assigned to the control group. 37 patients (43%; 95% CI 33–53) allocated to catheter-directed thrombolysis developed post-thrombotic syndrome, compared with 63 (71%; 95% CI 61–79) allocated to the control group (p<0·0001), corresponding to an absolute risk reduction of 28% (95% CI 14–42) and a number needed to treat of 4 (95% CI 2–7). Four (5%) patients assigned to catheter-directed thrombolysis and one (1%) to standard treatment had severe post-thrombotic syndrome (Villalta score =15 or presence of an ulcer). Quality-of-life scores with either assessment scale did not differ between the treatment groups. |
1 |
| 4. Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.[Erratum appears in Chest. 2012 Dec;142(6):1698-1704]. Chest. 141(2 Suppl):e419S-e496S, 2012 Feb. |
Review/Other-Dx |
N/A |
To review recommendations for the use of antithrombotic agents as well as the use of devices or surgical techniques in the treatment of patients with DVT and pulmonary embolism (PE). |
No results stated in abstract. |
4 |
| 5. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report. Chest. 149(2):315-352, 2016 Feb. |
Review/Other-Tx |
N/A |
To provide recommendations for the use of antithrombotic agents as well as the use of devices or surgical techniques in the treatment of patients with DVT and pulmonary embolism (PE), which are collectively referred to as VTE. |
For VTE and no cancer, as long-term anticoagulant therapy, we suggest dabigatran (Grade 2B), rivaroxaban (Grade 2B), apixaban (Grade 2B), or edoxaban (Grade 2B) over vitamin K antagonist (VKA) therapy, and suggest VKA therapy over low-molecular-weight heparin (LMWH; Grade 2C). For VTE and cancer, we suggest LMWH over VKA (Grade 2B), dabigatran (Grade 2C), rivaroxaban (Grade 2C), apixaban (Grade 2C), or edoxaban (Grade 2C). We have not changed recommendations for who should stop anticoagulation at 3 months or receive extended therapy. For VTE treated with anticoagulants, we recommend against an inferior vena cava filter (Grade 1B). For DVT, we suggest not using compression stockings routinely to prevent PTS (Grade 2B). For subsegmental pulmonary embolism and no proximal DVT, we suggest clinical surveillance over anticoagulation with a low risk of recurrent VTE (Grade 2C), and anticoagulation over clinical surveillance with a high risk (Grade 2C). We suggest thrombolytic therapy for pulmonary embolism with hypotension (Grade 2B), and systemic therapy over catheter-directed thrombolysis (Grade 2C). For recurrent VTE on a non-LMWH anticoagulant, we suggest LMWH (Grade 2C); for recurrent VTE on LMWH, we suggest increasing the LMWH dose (Grade 2C). |
4 |
| 6. Minocha J, Smith AM, Kapoor BS, et al. ACR Appropriateness Criteria® Radiologic Management of Venous Thromboembolism-Inferior Vena Cava Filters. J Am Coll Radiol. 2019;16:S214-S26. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for radiologic management of venous thromboembolism-inferior vena cava filters |
No results stated in abstract. |
4 |
| 7. Muriel A, Jimenez D, Aujesky D, et al. Survival effects of inferior vena cava filter in patients with acute symptomatic venous thromboembolism and a significant bleeding risk. Journal of the American College of Cardiology. 63(16):1675-83, 2014 Apr 29. |
Experimental-Tx |
40,142 eligible patients |
To investigate the survival effects of inferior vena cava filters in patients with venous thromboembolism (VTE) who had a significant bleeding risk. |
Of the 40,142 eligible patients who had acute symptomatic VTE, 371 underwent filter placement because of known significant bleeding risk. A total of 344 patients treated with a filter were matched with 344 patients treated without a filter. Propensity score-matched pairs showed a nonsignificant trend toward lower risk of all-cause death for filter insertion compared with no insertion (6.6% vs. 10.2%; p = 0.12). The risk-adjusted PE-related mortality rate was lower for filter insertion than no insertion (1.7% vs. 4.9%; p = 0.03). Risk-adjusted recurrent VTE rates were higher for filter insertion than for no insertion (6.1% vs. 0.6%; p < 0.001). |
1 |
| 8. Vedantham S, Goldhaber SZ, Julian JA, et al. Pharmacomechanical Catheter-Directed Thrombolysis for Deep-Vein Thrombosis. New England Journal of Medicine. 377(23):2240-2252, 2017 12 07. |
Experimental-Tx |
692 Patients |
To determine whether pharmacomechanical catheter-directed thrombolysis prevents the post-thrombotic syndrome in patients with proximal deep-vein thrombosis. |
Between 6 and 24 months, there was no significant between-group difference in the percentage of patients with the post-thrombotic syndrome (47% in the pharmacomechanical-thrombolysis group and 48% in the control group; risk ratio, 0.96; 95% confidence interval [CI], 0.82 to 1.11; P = 0.56). Pharmacomechanical thrombolysis led to more major bleeding events within 10 days (1.7% vs. 0.3% of patients, P = 0.049), but no significant difference in recurrent venous thromboembolism was seen over the 24-month follow-up period (12% in the pharmacomechanical-thrombolysis group and 8% in the control group, P = 0.09). Moderate-to-severe post-thrombotic syndrome occurred in 18% of patients in the pharmacomechanical-thrombolysis group versus 24% of those in the control group (risk ratio, 0.73; 95% CI, 0.54 to 0.98; P = 0.04). Severity scores for the post-thrombotic syndrome were lower in the pharmacomechanicalthrombolysis group than in the control group at 6, 12, 18, and 24 months of follow-up (P<0.01 for the comparison of the Villalta scores at each time point), but the improvement in quality of life from baseline to 24 months did not differ significantly between the treatment groups. |
1 |
| 9. Burgstaller JM, Steurer J, Held U, Amann-Vesti B. Efficacy of compression stockings in preventing post-thrombotic syndrome in patients with deep venous thrombosis: a systematic review and metaanalysis. [Review]. Vasa. 45(2):141-7, 2016. |
Meta-analysis |
5 RCTs with a total of 1393 patients. |
To synthesize the updated results of an earlier systematic review on the preventive efficacy of active compression stockings in patients with diagnosed proximal deep venous thrombosis (DVT) by including the results of recently published trials, and to identify details to explain heterogeneous results. |
In three RCTs, patients started to wear compression stockings, placebo stockings or no stockings within the first three weeks after the diagnosis of DVT. The results of two RCTs indicate a statistically significant reduction in post-thrombotic syndrome (PTS) of 50% or more after two or more years. The result of one RCT shows no preventive effect of compression stockings at all. Due to the heterogeneity of the study results, the authors refrained from pooling the results of the RCTs. In a further RCT, randomization to groups with and without compression stockings took place six months after the diagnosis of DVT, and in another RCT, only patients with the absence of PTS one year after the diagnosis of DVT were analyzed. One RCT revealed a significant reduction in symptoms, whereas another RCT failed to show any benefit of using compression stockings. |
Inadequate |
| 10. Jayaraj A, Meissner M. Impact of graduated compression stockings on the prevention of post-thrombotic syndrome - results of a randomized controlled trial. Phlebology. 30(8):541-8, 2015 Sep. |
Experimental-Tx |
69 Patients |
To assess the role of graduated compression stockings in the prevention of post-thrombotic syndrome with a randomized controlled study that uses multiple scoring instruments. |
As measured by both Villalta-Prandoni Score and Venous Clinical Severity Score instruments, the graduated compression stockings group had a lower incidence of post-thrombotic syndrome compared to the control group, but only when one month was used as cut off time for the first diagnosis of post-thrombotic syndrome. When 6 or 12 months were used, there was no difference in the incidence of post-thrombotic syndrome between the two groups. The burden of post-thrombotic syndrome was significantly more when the Villalta-Prandoni Score instrument (~75%) was used as compared to the Venous Clinical Severity Score instrument (~30%) at 24 months’ follow-up. Obesity was the only statistically significant predictor for the development of post-thrombotic syndrome. |
1 |
| 11. Kahn SR, Shapiro S, Wells PS, et al. Compression stockings to prevent post-thrombotic syndrome: a randomised placebo-controlled trial. Lancet. 383(9920):880-8, 2014 Mar 08. |
Experimental-Tx |
806 Patients |
To assess the efficacy of elastic compression stockings (ECS), compared with placebo stockings, for the prevention of post-thrombotic syndrome (PTS). |
From 2004 to 2010, 410 patients were randomly assigned to receive active ECS and 396 placebo ECS. The cumulative incidence of PTS was 14·2% in active ECS versus 12·7% in placebo ECS (hazard ratio adjusted for centre 1·13, 95% CI 0·73–1·76; p=0·58). Results were similar in a prespecified per-protocol analysis of patients who reported frequent use of stockings. |
1 |
| 12. Mol GC, van de Ree MA, Klok FA, et al. One versus two years of elastic compression stockings for prevention of post-thrombotic syndrome (OCTAVIA study): randomised controlled trial. BMJ. 353:i2691, 2016 May 31. |
Experimental-Tx |
518 Patients |
To study whether stopping elastic compression stockings (ECS) after 12 months is non-inferior to continuing them for 24 months after proximal deep venous thrombosis. |
518 patients compliant with ECS and free of postthrombotic syndrome were randomised one year after diagnosis of deep venous thrombosis to stop orcontinue ECS therapy for another year. In the stop-ECS group, 51 of 256 patients developed post-thrombotic syndrome, with an incidence of 19.9% (95%confidence interval 16% to 24%). In the continue-ECS group, 34 of 262 patients developed post-thrombotic syndrome (incidence 13.0%, 9.9% to 17%), of whom 85% used ECS six or seven days a week during the study period, for an absolute difference of 6.9% (95% confidence interval upper limit 12.3%). Because the upper limit of the 95% confidence interval exceeds the predefined margin of 10%, non-inferiority was not reached. The number needed to treat to prevent one case of post-thrombotic syndrome by continuing ECS was 14 (95% confidence interval lower limit 8). Quality of life did not differ between the two groups. |
1 |
| 13. Skervin AL, Thapar A, Franchini AJ, Prandoni P, Shalhoub J, Davies AH. Systematic Review and Meta-Analysis of Utility of Graduated Compression Stockings in Prevention of Post-Thrombotic Syndrome. [Review]. European Journal of Vascular & Endovascular Surgery. 51(6):838-45, 2016 Jun. |
Meta-analysis |
3 RCTs with 1177 Patients |
To examine the preventative effect of graduated compression stockings (GCS) versus no compression, in addition to routine anticoagulation, in adults with new proximal deep vein thrombosis (DVT), for all post-thrombotic syndrome (PTS) in randomized controlled trials. |
A total of 686 articles were screened. Three randomised controlled trials inclusive of 1,177 patients were eligible for inclusion. PTS developed in 49-70% of control patients at 5 years. High statistical heterogeneity was observed between trials (all PTS: I2= 0.94; severe PTS: I2= 0.79). The risk difference in PTS incidence between control and GCS arms varied from 0% to 39% between trials. In trials with a higher baseline prevalence of PTS, a visual trend towards more benefit with GCS was noted. |
Good |
| 14. Subbiah R, Aggarwal V, Zhao H, Kolluri R, Chatterjee S, Bashir R. Effect of compression stockings on post thrombotic syndrome in patients with deep vein thrombosis: a meta-analysis of randomised controlled trials. The Lancet Haematology. 3(6):e293-300, 2016 Jun. |
Meta-analysis |
6 RCTs, 1462 patients |
To determine the effectiveness of elastic compression stockings on preventing post thrombotic syndrome in patients with deep vein thrombosis. |
Use of elastic compression stockings was not associated with prevention of post thrombotic syndrome compared with controls (OR 0·56 [95% CI 0·27–1·16]; 36% [269/739] vs 45% [322/723]; p=0·12). Subgroup sensitivity analysis showed that elastic compression stockings were not associated with prevention of post thrombotic syndrome despite trying to account for heterogeneity (OR 0·63 [95% CI 0·29–1·33]; 27% [63/234] vs 37% [85/231]; p=0·23), diagnosis by Villalta scoring (0·81 [0·36–1·84]; 43% [228/535] vs 45% [235/517]; p=0·62), nor those that patients randomised within 1 month of diagnosis (0·57 [0·22–1·45]; 41% [258/631] vs 49% [304/615]; p=0·24). Secondary outcomes such as mortality (OR 0·98 [95% CI 0·68–1·41]; 10% [68/703] vs 10% [67/690]; p=0·92) or recurrence of deep vein thrombosis (OR 0·93 [95% CI 0·66–1·31]; 6·4% [70/1094] vs 6·8% [73/1066]; p=0·69) did not differ significantly between the treatment and control groups. |
Good |
| 15. Meissner MH.. Rationale and indications for aggressive early thrombus removal. [Review]. Phlebology. 27 Suppl 1:78-84, 2012 Mar. |
Review/Other-Dx |
N/A |
To review strategies of early thrombus removal with the goal of reducing the incidence of the post-thrombotic syndrome by restoring venous patency and preserving valvular function. |
No results stated in abstract. |
4 |
| 16. Watson L, Broderick C, Armon MP. Thrombolysis for acute deep vein thrombosis. [Review][Update of Cochrane Database Syst Rev. 2014 Jan 23;(1):CD002783; PMID: 24452314]. Cochrane Database of Systematic Reviews. 11:CD002783, 2016 11 10. |
Review/Other-Tx |
17 RCTs with 1103 participants |
To assess the effects of thrombolytic therapy and anticoagulation versus anticoagulation in the management of people with acute deep vein thrombosis (DVT) of the lower limb as determined by the effects on pulmonary embolism, recurrent venous thromboembolism, major bleeding, post-thrombotic complications, venous patency and venous function. This is the third update of a review first published in 2004.ions, venous patency and venous function. |
Seventeen studies with 1103 participants were included. Complete clot lysis occurred significantly more often in the treatment group in early follow up (risk ratio (RR) 4.91; 95% confidence interval (CI) 1.66 to 14.53, P = 0.004) and at intermediate follow up (RR 2.37; 95% CI 1.48 to 3.80, P = 0.0004). A similar effect was seen for any degree of improvement in venous patency. Significantly less PTS occurred in those receiving thrombolysis, (RR 0.64; 95% CI 0.52 to 0.79, P < 0.0001). Leg ulceration was reduced although the data were limited by small numbers (RR 0.48; 95% CI 0.12 to 1.88, P = 0.29). Those receiving thrombolysis had significantly more bleeding complications (RR 2.23; 95% CI 1.41 to 3.52, P = 0.0006). Three strokes occurred in the treatment group, all in trials conducted pre-1990, and none in the control group. There was no significant effect on mortality detected at either early or intermediate follow up. Data on the occurrence of pulmonary embolism (PE) and recurrent DVT were inconclusive. Systemic thrombolysis is now not commonly used and catheter-directed thrombolysis (CDT) is the more favoured means of administration. This has been studied in iliofemoral DVT, and results from two trials are consistent with those from trials of systemic thrombolysis in DVT at other levels of occlusion. |
4 |
| 17. Comerota AJ, Kearon C, Gu CS, et al. Endovascular Thrombus Removal for Acute Iliofemoral Deep Vein Thrombosis. Circulation. 139(9):1162-1173, 2019 Feb 26. |
Experimental-Tx |
391 patients |
To report the benefits and risks of pharmacomechanical catheter–directed thrombolysis (PCDT) in the patients in the ATTRACT (Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis) Trial who presented with acute iliofemoral deep vein thrombosis (DVT). |
Between 6 and 24 months, there was no difference in the occurrence of postthrombotic syndrome (PTS) (Villalta scale =5 or ulcer: 49% PCDT versus 51% No-PCDT; risk ratio, 0.95; 95% CI, 0.78–1.15; P=0.59). PCDT led to reduced PTS severity as shown by lower mean Villalta and Venous Clinical Severity Scores (P<0.01 for comparisons at 6, 12, 18, and 24 months), and fewer patients with moderate-or-severe PTS (Villalta scale =10 or ulcer: 18% versus 28%; risk ratio, 0.65; 95% CI, 0.45–0.94; P=0.021) or severe PTS (Villalta scale =15 or ulcer: 8.7% versus 15%; risk ratio, 0.57; 95% CI, 0.32–1.01; P=0.048; and Venous Clinical Severity Score =8: 6.6% versus 14%; risk ratio, 0.46; 95% CI, 0.24–0.87; P=0.013). From baseline, PCDT led to greater reduction in leg pain and swelling (P<0.01 for comparisons at 10 and 30 days) and greater improvement in venous disease–specific quality of life (Venous Insufficiency Epidemiological and Economic Study Quality of Life unit difference 5.6 through 24 months, P=0.029), but no difference in generic quality of life (P>0.2 for comparisons of SF-36 mental and physical component summary scores through 24 months). In patients having PCDT versus No-PCDT, major bleeding within 10 days occurred in 1.5% versus 0.5% (P=0.32), and recurrent venous thromboembolism over 24 months was observed in 13% versus 9.2% (P=0.21). |
1 |
| 18. Hogg K, Kimpton M, Carrier M, Coyle D, Forgie M, Wells P. Estimating quality of life in acute venous thrombosis. JAMA Internal Medicine. 173(12):1067-72, 2013 Jun 24. |
Observational-Dx |
216 Patients |
To measure the quality of life in the health states relating to thromboembolism cost-utility analyses. |
Two hundred fifteen responses were included in the analysis. Twenty-six percent had experienced both PE and DVT; 54%, DVT alone; and 20%, PE alone. Forty-two percent had experienced more than 1 episode of thrombosis, and 23% had had cancer-associated thrombosis. The median utility for acute DVT was 0.81 (interquartile range [IQR], 0.55-0.94); acute PE, 0.75 (IQR, 0.45- 0.91); major intracranial bleeding event, 0.15 (IQR,0.00-0.65); minor intracranial bleeding event, 0.75 (IQR, 0.55-0.92); and gastrointestinal bleeding event, 0.65 (IQR, 0.15-0.86). The median length of symptoms for DVT or PE was 1 week (IQR, <1-3 weeks). |
4 |
| 19. Cakir V, Gulcu A, Akay E, et al. Use of percutaneous aspiration thrombectomy vs. anticoagulation therapy to treat acute iliofemoral venous thrombosis: 1-year follow-up results of a randomised, clinical trial. Cardiovasc Intervent Radiol. 37(4):969-76, 2014 Aug. |
Experimental-Tx |
42 Patients |
To compare the efficacy of percutaneous aspiration thrombectomy (PAT) followed by standard anticoagulant therapy, with anticoagulation therapy alone, for the treatment of acute proximal lower extremity deep vein thrombosis. |
Deep venous systems became totally cleared of thrombi in 12 patients treated with PAT. The venous patency rates in month 12 were 57.1 and 4.76 % in the interventional and medical treatment groups, respectively. A statistically significant improvement was observed in clinical symptom scores of the interventional group (PAT) with or without stenting (4.23 ±0.51 before treatment; 0.81 ± 0.92 at month 12) compared with the medical treatment group (4.00 ± 0.63 before treatment; 2.43 ± 0.67 at month 12). During follow-up, four patients in the medical treatment and one in the interventional group developed pulmonary embolisms |
3 |
| 20. Holper P, Kotelis D, Attigah N, Hyhlik-Durr A, Bockler D. Longterm results after surgical thrombectomy and simultaneous stenting for symptomatic iliofemoral venous thrombosis. Eur J Vasc Endovasc Surg. 39(3):349-55, 2010 Mar. |
Observational-Dx |
45 Patients |
To evaluate the longterm outcome of venous thrombectomy and simultaneous stenting in patients with acute, symptomatic iliofemoral deep venous thrombosis (DVT). |
Median follow-up was 68 months (range 3e129). Primary and secondary patency rates were 74% (14/19) and 84% (16/19), respectively. Re-thrombosis occurred within seven days of operation in 26% (5/19). Procedure related mortality was zero. There was no case of late re-thrombosis. Four patients showed post-thrombotic sequelae (CEAP: C1, 2 or 3 s). No leg ulcer developed in any patient. |
4 |
| 21. Koopmann MC, McLafferty RB. Advances in Operative Thrombectomy for Lower Extremity Venous Thrombosis. [Review]. Surg Clin North Am. 98(2):267-277, 2018 Apr. |
Review/Other-Dx |
N/A |
To review how advances in Operative Thrombectomy can reduce the incidence of postthrombotic syndrome. |
No abstract available. |
4 |
| 22. Plate G, Eklof B, Norgren L, Ohlin P, Dahlstrom JA. Venous thrombectomy for iliofemoral vein thrombosis--10-year results of a prospective randomised study. Eur J Vasc Endovasc Surg. 14(5):367-74, 1997 Nov. |
Experimental-Tx |
30 Patients |
To study if venous thrombectomy prevents late post-thrombotic sequelae, venous obstruction reflux, and improves venous physiology following an acute iliofemoral venous thrombosis. |
Leg swelling was recorded in 12 (71%) and leg ulcers in three (18%) of the medical patients and in, respectively, six (46%) and one (8%) of the surgical patients. The surgical patients had less severe sequelae (class 0-2). Radionuclide angiography demonstrated that the iliac vein was more commonly occluded following medical (59%) than following surgical (17%) treatment (p<O.05). Duplex examination demonstrated slightly (n.s.) more reflux in the femoral and poptiteal veins in the medical group. Venous physiology (occlusion plethysmography, foot volumetry, and foot vein pressures) did not show any significant differences, although the medical group tended to have a more severe pathology. |
1 |
| 23. Rodriguez LE, Aboukheir-Aboukheir A, Figueroa-Vicente R, et al. Hybrid operative thrombectomy is noninferior to percutaneous techniques for the treatment of acute iliofemoral deep venous thrombosis. J Vasc Surg Venous Lymphat Disord. 5(2):177-184, 2017 03. |
Observational-Dx |
71 Patients |
To compare perioperative and intermediate outcomes of hybrid operative thrombectomy (HOT) versus percutaneous techniques (PT) as interventions for early thrombus removal. |
From July 2008 to May 2015, there were 71 consecutive patients who were treated with either PT (n = 31) or HOT (n = 40) for acute or subacute single-limb iliofemoral deep venous thrombosis (IFDVT). The left limb was the most common site of the IFDVT overall. Technical success (=50% resolution) was 100% for both groups, and >80% resolution was achieved in all patients treated with HOT. There were eight major bleeding events in the PT group compared with three in the HOT group (P = .04). PT patients had a significantly longer length of stay (13 vs 10 days; P = .028) compared with HOT. At 2-year duplex ultrasound examination, there was no difference between HOT and PT in mean reflux times at the femoral-popliteal segment. At 2 years, 85% and 87% of the patients (HOT vs PT, respectively) had not developed post-thrombotic syndrome, and there was no difference between the groups for mean Villalta score (2.1 ± 1.9 vs 2.3 ± 2; P = .79). |
3 |
| 24. Birn J, Vedantham S. May-Thurner syndrome and other obstructive iliac vein lesions: meaning, myth, and mystery. [Review]. Vascular Medicine. 20(1):74-83, 2015 Feb.Vasc Med. 20(1):74-83, 2015 Feb. |
Review/Other-Dx |
N/A |
To improve the knowledge base of vascular practitioners who make clinical decisions about the diagnosis and treatment of obstructive iliac vein lesions. |
No results stated in abstract. |
4 |
| 25. Hartung O, Benmiloud F, Barthelemy P, Dubuc M, Boufi M, Alimi YS. Late results of surgical venous thrombectomy with iliocaval stenting. J Vasc Surg. 47(2):381-7, 2008 Feb. |
Review/Other-Dx |
29 Patients |
To present long-term results of stenting of iliocaval occlusive lesions persisting after surgical venous thrombectomy, and to compare them with the literature. |
Neither perioperative death nor pulmonary embolism occurred. Four early complications occurred after stenting (13.8%). Median hospital length of stay was 8 days (range, 5-22 days). Median follow-up was 63 months (range, 2-137 months). Three late complications occurred (10.3 %): one rethrombosis due to stent crushing during pregnancy and two restenosis, which were treated by iterative stenting. At the end of the follow-up, the median venous clinical severity score was 3 (range 1-12) and the venous disability score was 1 (range 0-2). Primary, assisted primary and secondary patency rates were, respectively, 79%, 86%, and 86% at 12, 60, and 120 months. Patients with patent iliocaval segments had significantly fewer infrainguinal obstructive lesions (4% vs 50%) and a higher rate of valvular competence (76% vs 0%) than those who experienced rethrombosis. Venous scores were also worse in patients with rethrombosis. |
4 |
| 26. Mickley V, Schwagierek R, Rilinger N, Gorich J, Sunder-Plassmann L. Left iliac venous thrombosis caused by venous spur: treatment with thrombectomy and stent implantation. J Vasc Surg. 28(3):492-7, 1998 Sep. |
Observational-Tx |
77 Patients |
To determine the frequency of iliac venous spurs in left iliofemoral venous thrombosis and to report the results of interventional management of venous spurs after transfemoral venous thrombectomy. |
Among 61 patients with left-sided thrombosis, intraoperative phlebography revealed common iliac venous obstruction suggestive of venous spurs in 30 patients (49%). In 16 of 22 patients (73%) with untreated spurs, postoperative rethrombosis of the iliac vein was documented despite adequate anticoagulation. Only one of eight patients (13%) with stented spurs had reocclusion (chi2 test P < .01). |
4 |
| 27. Ming ZB, Li WD, Yuan RF, Li XQ, Ding WB. Effectiveness of catheter directed thrombolysis and stent implantation on iliofemoral vein thrombosis caused by iliac vein compression. Journal of Thrombosis & Thrombolysis. 44(2):254-260, 2017 Aug. |
Observational-Dx |
247 Patients |
To objectively assess the morbidity of post-thrombotic syndrome (PTS) in iliofemoral vein thrombosis treated with catheter-directed thrombolysis (CDT) and stenting under the protection of inferior vena cava (IVC) filter. |
A total of 247 patients who underwent CDT and IVC filter insertion for iliofemoral vein thrombosis and were found stenosis in the iliac vein after CDT were included in this study. Among them, 74 patients suffered PTS diagnosed via Villalta scale. Comparison with patients without stent implantation and filter withdrawal, patients with stent implantation and filter withdrawal had a less risk of PTS, but patients with a lesion in the left or bilateral proximal deep vein had a more risk of PTS. Cox regression found that stent implantation was a preventive measure to prevent PTS (OR 0.541, 95% CI 0.334–0.876, p?=?0.012). The Kaplan–Meier curve found that patients with stent implantation had a less ratio of PTS occurrence (P?=?0.008). |
4 |
| 28. Park JY, Ahn JH, Jeon YS, Cho SG, Kim JY, Hong KC. Iliac vein stenting as a durable option for residual stenosis after catheter-directed thrombolysis and angioplasty of iliofemoral deep vein thrombosis secondary to May-Thurner syndrome. Phlebology. 29(7):461-70, 2014 Aug. |
Observational-Dx |
51 Patients |
To evaluate the primary patency and clinical outcomes after stenting for residual iliac venous stenosis during catheter-directed thrombolysis treatment of acute iliofemoral deep vein thrombosis arising from May-Thurner syndome. |
Fifty-one patients were enrolled. The median age was 70 years (range 44-86). There were 37 females (72.5%). The duration of symptoms of acute deep vein thrombosis before catheter-directed thrombolysis treatment was 6 days (median, range 1-33). Self-expanding stent was used for iliac vein stenting. Initial technical success rate was 94.1%. There were two complications (3.9%): an arteriovenous fistula formation in left popliteal area and a right inguinal hematoma. Mean follow-up was 15.6 months (range 6 days-80.8 months). Primary patency rate after iliac vein stenting was 95.8% at 6 months, 87.5% at 12 months and 84.3% at 24 months. Four patients had recurrent thrombotic occlusion (7.8%) during the follow-up. |
4 |
| 29. Zhu QH, Zhou CY, Chen Y, et al. Percutaneous manual aspiration thrombectomy followed by stenting for iliac vein compression syndrome with secondary acute isolated iliofemoral deep vein thrombosis: a prospective study of single-session endovascular protocol. European Journal of Vascular & Endovascular Surgery. 47(1):68-74, 2014 Jan.Eur J Vasc Endovasc Surg. 47(1):68-74, 2014 Jan. |
Observational-Tx |
26 Patients |
To evaluate the feasibility, safety, and effectiveness of single-session endovascular treatment with manual aspiration thrombectomy (MAT) as the first-line method of thrombus removal for iliac vein compression syndrome (IVCS) with secondary acute isolated iliofemoral deep vein thrombosis (DVT). |
Single-session endovascular procedures were performed successfully in all patients. The mean procedure time was 67 minutes (ranging from 45 to 90 minutes). Complete thrombus removal, including almost 100% of removal in 24 patients and little residual thrombus (<5%) in two, was achieved after repeated MAT. Thrombolysis was used in these two patients. Complete symptomatic relief was achieved in 25 patients (96%) and partial relief in one. The hospital stay ranged from 2 to 4 days (mean 2.7 days). Recurrent thrombosis within the stent was observed in one case and recanalized with thrombolysis. The 1-year primary and secondary patency rate was 96% and 100%, respectively. No symptomatic pulmonary embolization, bleeding, and venous reflux were observed. Five patients complained about transitory low back pains during balloon angioplasty. |
2 |
| 30. Igari K, Kudo T, Toyofuku T, Jibiki M, Inoue Y. Surgical thrombectomy and simultaneous stenting for deep venous thrombosis caused by iliac vein compression syndrome (May-Thurner syndrome). Annals of Thoracic & Cardiovascular Surgery. 20(6):995-1000, 2014. |
Observational-Tx |
8 Patients |
To evaluate the outcomes of surgical thrombectomy and simultaneous stenting of patients with DVT due to May-Thurner syndrome (MTS). |
In all patients, the procedure was successful in achieving re-canalisation of the iliofemoral veins at the end of the operation. Perioperatively, there was no mortality and there was no case of clinically detected pulmonary embolism. Rethrombosis occurred within seven days of operation in 2 patients. During the follow-up period (mean; 16 months), 6 of 8 patients kept patent stents. |
4 |
| 31. Laohapensang K, Hanpipat S, Aworn S, Orrapin S. Surgical venous thrombectomy for phlegmasia cerulea dolens and venous gangrene of the lower extremities. Journal of the Medical Association of Thailand. 96(11):1463-9, 2013 Nov. |
Observational-Tx |
15 Patients |
To evaluate surgical management of patients with phlegmasia cerulea dolens (PCD) and venous gangrene due to iliofemoral acute deep vein thrombosis (DVT). |
All 15 patients underwent surgery within 10 days of the onset of symptoms. Six patient with impending gangrene and failure for initial management with bed rest, extremity elevation, fluid resuscitation, and systemic anticoagulation for six to 12 hours underwent iliofemoral venous thrombectomy and distal arteriovenous fistula (AVF) can preserve limbs. In nine patients with venous gangrene that underwent iliofemoral thrombectomy below knee had transmetatarsal amputation done after decreasing leg edema. All patients underwent caval filter insertion before venous thrombectomy. There was no pulmonary embolism (PE) or immediate mortality. Anticoagulation treatment was given for at least six months. The distal arteriovenous fistula was closed as a secondary operation six weeks after initial operation. On the follow-up, 10-year period, seven patients died from the advanced carcinomas 7, 9, 9, 12, 14, 18, and 20 months after an operation. The remaining eight patients have regularly followed-up over 120 months. Three patients (37.5%) had recurrence of DVT; the rate of recanalization in common iliac veins on duplex scan was 100%. Three patients (37.5%) developed reflux in at least one deep venous segment without signs and symptoms of postphlebitic syndrome. |
4 |
| 32. Avgerinos ED, Hager ES, Naddaf A, Dillavou E, Singh M, Chaer RA. Outcomes and predictors of failure of thrombolysis for iliofemoral deep venous thrombosis. Journal of Vascular Surgery. 3(1):35-41, 2015 Jan. |
Observational-Dx |
93 Patients |
To determine longer term outcomes of catheter-based interventions for iliofemoral deep venous thrombosis (IFDVT) and to identify predictors of immediate and mid-long term failures that would guide optimal patient selection. |
During the study period, 93 patients (118 limbs; mean age, 49.4 ± 16.2 years; 47 women) with symptoms averaging11.1 ± 9.6 days in duration were treated with various combinations of CDT or pharmacomechanical thrombolysis; in 52 (56%), at least one iliocaval stent was deployed. Immediate treatment failure was seen in 11 patients (12%) predicted by the preoperative indication “phlegmasia” (odds ratio, 3.12; P [ .042) and recent surgery (odds ratio, 19.6; P [ .018). At a mean ultrasonographic follow-up of 16 % 14 months (range, 1-65 months), six more patients sustained a rethrombosis, accounting for an overall 3-year primary patency of 72.1%. In the long-term model, loss of primary patency was associated with recent surgery (hazard ratio [HR], 4.04; P [ .023), malignant disease (HR, 6.75; P [.016), and incomplete thrombolysis (#50%) (HR, 5.83; P < .001). By stratification of PTS on the basis of postprocedure failures, at 2 years PTS occurred in 50.6% of patients and in 16.3% of patients without failure (P < .001). |
3 |
| 33. Ruihua W, Xin W, Guang L, et al. Technique and Clinical Outcomes of Combined Stent Placement for Postthrombotic Chronic Total Occlusions of the Iliofemoral Veins. Journal of Vascular & Interventional Radiology. 28(3):373-379, 2017 Mar. |
Observational-Dx |
81 Patients |
To evaluate the technical aspects and early clinical results of combined stent placement for the management of postthrombotic syndrome (PTS) in chronic total occlusions (CTOs) of the iliofemoral veins. |
Percutaneous recanalization was successful in 77 of 81 limbs (95.1%). Stents were deployed in all iliofemoral occlusions, with two stents in 63 lesions (77.8%) lesions and three stents in 18 lesions (22.2%). Venous perforation occurred in 32 patients (37.4%) and was resolved in all cases after stent placement. Back pain occurred during balloon angioplasty (93.8%) and persisted after stent placement in 56.8% of patients. However, the symptoms were self-limiting without further therapy. QOL and Villalta scores were significantly improved during a median follow-up of 19 months (range, 1-38 mo; P < .01). The 2-year primary, primary assisted, and secondary cumulative stent patency rates were 81.5%, 91.4%, and 93.8%, respectively |
4 |
| 34. Sarici IS, Yanar F, Agcaoglu O, et al. Our early experience with iliofemoral vein stenting in patients with post-thrombotic syndrome. Phlebology. 29(5):298-303, 2014 Jun. |
Review/Other-Dx |
52 Patients |
To report and describe the one-year outcome and efficacy of balloon angioplasty and stenting for the treatment of post-thrombotic syndrome (PTS) in iliofemoral vein segments. |
Stenting was successfully accomplished in all patients. Coagulation abnormality was identified in 21 subjects (40.3%). CEAP grades were as follows: C3 in 19 patients, C4 in 24 patients, C5 in one patient and C6 in eight patients. According to Villalta scores, three patients were mild, seven patients were moderate and 42 patients were severe PTS. VCSS, Villalta scale and CIVTQ-20 showed a significant decrease in the severity of PTS signs and symptoms (P < 0.001). The calf and middle thigh circumferences decreased significantly on both sides (P < 0.001). |
4 |
| 35. Ye K, Lu X, Jiang M, et al. Technical details and clinical outcomes of transpopliteal venous stent placement for postthrombotic chronic total occlusion of the iliofemoral vein. Journal of Vascular & Interventional Radiology. 25(6):925-32, 2014 Jun.J Vasc Interv Radiol. 25(6):925-32, 2014 Jun. |
Observational-Dx |
110 Patients |
To evaluate the technical aspects and early clinical results of stent placement for managing postthrombotic chronic total occlusion (CTO) of the iliofemoral vein through ipsilateral popliteal access. |
Percutaneous recanalization was successful in 112 of 118 limbs (95%). The mean duration of the procedure was 43 minutes (range, 10-120 min). The quality of life and Villalta scores were significantly improved (P < .01). The 3-year primary, assisted primary, and secondary cumulative stent patency rates were 70%, 90%, and 94%. During a median follow-up period of 25 months (range, 1-52 mo), the relief rates of severe leg pain (visual analog scale > 5) and severe leg swelling (grade 3) were 72% (49 of 68) and 70% (64 of 91), respectively, and the healing of ulcers was successful in 78% (36 of 46) of the cases. After stent placement, the limbs with visible remaining collateral circulation had a higher rate of early in-stent thrombosis (22.5% vs 6.1%; P = .007). The patients with long stents extending below the inguinal ligament had a higher rate of in-stent restenosis (hazard ratio = 1.77-6.5; P = .0146). |
4 |
| 36. Yin M, Shi H, Ye K, et al. Clinical Assessment of Endovascular Stenting Compared with Compression Therapy Alone in Post-thrombotic Patients with Iliofemoral Obstruction. European Journal of Vascular & Endovascular Surgery. 50(1):101-7, 2015 Jul. |
Observational-Tx |
216 Patients |
To evaluate the clinical results of stent placement in post-thrombotic patients with iliofemoral obstruction compared with results in those treated with elastic compression stockings (ECS). |
Percutaneous iliofemoral venous stenting was successful in 116 of 122 patients (95.1%) without major complications. Follow up periods ranged from 3 to 58 months (median 21 months). Cumulative primary, assisted primary, and secondary stent patency rates at 3 years were 68.9%, 79.0%, and 91.6%, respectively. Among patients with severe PTS, the Villalta score decreased significantly with endotreatment, compared to the score of those treated by ECS therapy (16.12 4.91 vs. 10.98 5.89, p < .01). However, there was no significant score improvement between the two therapies in patients with moderate PTS (6.59 2.37 vs. 5.75 3.03, p ¼ .22). There was a significantly higher 24 month recurrence free ulcer healing rate in the endotreatment groups (86.6% vs. 70.6%, p < .01). Both edema and pain improved significantly in the two groups. The popliteal vein reflux rate showed no significant change after endotreatment. |
2 |
| 37. Zhang X, Ren Q, Jiang X, et al. A prospective randomized trial of catheter-directed thrombolysis with additional balloon dilatation for iliofemoral deep venous thrombosis: a single-center experience. Cardiovascular & Interventional Radiology. 37(4):958-68, 2014 Aug. |
Experimental-Tx |
386 Patients |
To conduct a prospective randomized controlled single-centre clinical trial to compare catheter-directed thrombolysis (CDT) alone with CDT with additional balloon dilatation for the treatment of iliofemoral DVT. |
Seven hundred twenty-two patients were screened, and 386 eligible patients were randomized. No significant difference for mean total Villalta score was observed between the intervention group (4.20 ± 3.05) and the control group (4.89 ± 3.45). However, post hoc analysis of the scores in subacute patients showed significant differences between the intervention group and the control group from 1 month (6.79 ± 4.23, 8.28 ± 5.03, P = 0.02) to 24 months (4.21 ± 3.08, 5.67 ± 3.71, P = 0.006). A significant difference was also observed in subacute patients at the end of follow-up for VEINES-QOL/Sym (52.87 ± 6.52, 50.31 ± 6.07, P = 0.009; 51.87 ± 6.37, 49.72 ± 5.96, P = 0.02) and SF-36 PCS/MCS (45.02 ± 12.07, 41.13 ± 11.68, P = 0.03; 53.26 ± 11.43, 49.50 ± 11.06, P = 0.03). |
1 |
| 38. Vogel D, Comerota AJ, Al-Jabouri M, Assi ZI. Common femoral endovenectomy with iliocaval endoluminal recanalization improves symptoms and quality of life in patients with postthrombotic iliofemoral obstruction. Journal of Vascular Surgery. 55(1):129-35, 2012 Jan. |
Observational-Dx |
5 Patients |
To report preliminary observations of common femoral endovenectomy and intraoperative endoluminal recanalization of the iliac veins in patients with incapacitating postthrombotic iliofemoral obstruction. |
Five patients were followed for more than 6 months and form the basis of the long-term analysis. Alldemonstrated significant improvement in their venous scores postoperatively. The VCSS preoperatively was 17 and fellto 9.8 postoperatively (P = .02). The Villalta scale dropped from 13.6 preoperatively to 6.0 postoperatively (P = .002).The VEINES-QOL/Sym questionnaire, a sensitive marker of patient quality of life and symptom status, was improved(P = .01 and .02, respectively). |
4 |
| 39. Pokrovsky A, Ignatyev I, Gradusov E. First Experience of Performing Hybrid Operations in Chronic Venous Obstructions of Iliofemoral Segments in Patients With Postthrombotic Syndrome. Vasc Endovascular Surg. 51(7):447-452, 2017 Oct. |
Observational-Dx |
12 Patients |
To assess the first results of hybrid operations in chronic venous obstructions of iliofemoral segments in patients with postthrombotic syndrome (PTS). |
Technical success of the procedure was 92%. The outcomes of hybrid operations after 7 months were followed up in 6 patients and in 4 patients in 3 months. Secondary patency rates of the stented iliac veins amounted to 100%. No recurrences of venous ulcers were observed. Median Villalta scores improved from 15 to 7 ( P = .012). |
4 |
| 40. Shaydakov E, Porembskaya O, Geroulakos G. The May-Husni Procedure: A Reappraisal. [Review]. Eur J Vasc Endovasc Surg. 50(4):513-7, 2015 Oct. |
Review/Other-Dx |
12 Patients |
To review the literature on the May-Husni procedure, and assess the criteria for the selection of patients who may benefit from this procedure. |
The saphenopopliteal bypass remained patent in all patients at follow up. The development of reflux ofthe saphenous conduit in four patients did not affect the clinical improvement. Venous claudication resolved,hyper-pigmentation improved, and pain was relieved in all patients. Recanalization of the femoral vein 3 yearsfollowing thrombosis was followed by recurrence of the post-thrombotic symptoms in two patients. |
4 |
| 41. Bates SM, Middeldorp S, Rodger M, James AH, Greer I. Guidance for the treatment and prevention of obstetric-associated venous thromboembolism. J Thromb Thrombolysis. 41(1):92-128, 2016 Jan. |
Review/Other-Dx |
N/A |
To provide practical clinical guidance on the prevention and treatment of obstetric-associated VTE based on existing guidelines and consensus expert opinion based on available literature where guidelines are lacking. |
No results stated in abstract. |
4 |
| 42. Bloom AI, Farkas A, Kalish Y, Elchalal U, Spectre G. Pharmacomechanical catheter-directed thrombolysis for pregnancy-related iliofemoral deep vein thrombosis. J Vasc Interv Radiol. 26(7):992-1000, 2015 Jul. |
Observational-Dx |
11 Patients |
To evaluate outcomes of pharmacomechanical catheter-directed thrombolysis (PCDT) during pregnancy and postpartum. |
Thrombus extended into the inferior vena cava in 5 patients (45%) and into popliteal/tibial veins in 7 (64%). Four patients (36%) had synchronous pulmonary embolism and three had May–Thurner compression. Median interval from diagnosis to PCDT was 5 days (range, 2–68 d); median duration of urokinase infusion was 27 hours (range, 16–72 h). Greater than 90% clot lysis was achieved in 9 of 11 patients (82%). Metal stents were placed in 8 of 11 patients (73%). A self-limiting popliteal hematoma developed in 1 patient, and 2 had early recurrent thrombosis requiring repeat PCDT. At median 20-month follow-up, nonocclusive thrombus was seen in 5 patients. No patient developed PTS. Three patients, all with stents, had uneventful pregnancies after PCDT. |
4 |
| 43. Devis P, Knuttinen MG. Deep venous thrombosis in pregnancy: incidence, pathogenesis and endovascular management. [Review]. Cardiovasc. diagn. ther.. 7(Suppl 3):S309-S319, 2017 Dec. |
Review/Other-Dx |
N/A |
To review risk factors, pathogenesis, complications, diagnostic criteria and tools, prophylaxis, medical and endovascular management of deep venous thrombosis (DVT) during pregnancy. |
No results stated in abstract. |
4 |
| 44. Herrera S, Comerota AJ, Thakur S, et al. Managing iliofemoral deep venous thrombosis of pregnancy with a strategy of thrombus removal is safe and avoids post-thrombotic morbidity. Journal of Vascular Surgery. 59(2):456-64, 2014 Feb. |
Review/Other-Dx |
13 Patients |
To review short- and long-term outcomes of 13 patients with extensive deep venous thrombosis (DVT) of pregnancy treated with a strategy of thrombus removal. |
CDT and/or PMT were used in 11 patients. Two patients underwent venous thrombectomy alone, and onepatient had operative thrombectomy as an adjunct to CDT and PMT. Each patient had complete or near-completethrombus resolution and rapid improvement in clinical symptoms. Eight of 11 having CDT or PMT underwent venoplastyand stenting of the involved iliac veins. Twelve of the 13 delivered healthy infants at term. One patient opted fortermination of her pregnancy. Mean patient and gestational ages were 26 years and 26 weeks, respectively. Mean followupwas 1.3 years, with only one recurrence. Duplex ultrasonography demonstrated patent veins in all but one patient andnormal valve function in 10 patients. Eleven patients had Villalta scores <5 (considered normal), with a mean score of 0.7. |
4 |
| 45. Pillny M, Sandmann W, Luther B, et al. Deep venous thrombosis during pregnancy and after delivery: indications for and results of thrombectomy. J Vasc Surg. 37(3):528-32, 2003 Mar. |
Observational-Tx |
97 Patients |
To discuss anticoagulation therapy and thrombectomy as treatment options for venous thromboembolism during pregnancy and puerperium. |
Surgery was performed without any maternal death or pulmonary embolization. A cesarean section was carried out during the same anesthesia in 11 cases. Thrombectomy was completed with construction of a temporary AVF in 90 patients (92.8%). One fetal death occurred in the recovery room for unknown reasons. In the early postoperative course, 16 patients (16.5%) underwent redo surgery for rethrombosis with or without the occlusion of the fistula. In 14 of these patients, the venous system remained patent thereafter. Fetal or neonatal death occurred in five cases 2 to 10 weeks after surgery, mainly because of abruption of the placenta probably from anticoagulation. Among 247 preoperatively occluded anatomic regions, 221 could be restored, and the secondary patency rate amounted to 89.5%. After a mean follow-up period of 6 years, 49 patients (56.3%) were seen without a postphlebitic syndrome, and only three patients (3.5%) had had a leg ulcer develop. |
2 |
| 46. American College of Radiology. ACR–SPR Practice Parameter for the Safe and Optimal Performance of Fetal Magnetic Resonance Imaging (MRI). Available at: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/mr-fetal.pdf |
Review/Other-Dx |
N/A |
To promote safe and optimal performance of fetal magnetic resonance imaging (MRI). |
No abstract available. |
4 |
| 47. American College of Radiology. ACR-SPR Practice Parameter for Imaging Pregnant or Potentially Pregnant Patients with Ionizing Radiation. Available at: http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/Pregnant_Patients.pdf. |
Review/Other-Dx |
N/A |
To assist practitioners in providing appropriate radiologic care for pregnant or potentially pregnant adolescents and women by describing specific training, skills and techniques. |
No abstract available. |
4 |
| 48. American College of Radiology. ACR-ACOG-AIUM-SMFM-SRU Practice Parameter for the Performance of Standard Diagnostic Obstetrical Ultrasound. Available at: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/us-ob.pdf |
Review/Other-Dx |
N/A |
To promote the safe and effective use of diagnostic and therapeutic radiology by describing the key elements of standard ultrasound examinations in the first, second, and third trimesters of pregnancy. |
No abstract available. |
4 |
| 49. American College of Radiology. Manual on Contrast Media. Available at: https://www.acr.org/Clinical-Resources/Contrast-Manual. |
Review/Other-Dx |
N/A |
To assist radiologists in recognizing and managing risks associated with the use of contrast media. |
No abstract available. |
4 |
| 50. Expert Panel on MR Safety, Kanal E, Barkovich AJ, et al. ACR guidance document on MR safe practices: 2013. J Magn Reson Imaging. 37(3):501-30, 2013 Mar. |
Review/Other-Dx |
N/A |
To help guide MR practitioners regarding MR safety issues and provide a basis for them to develop and implement their own MR policies and practices. |
No abstract available. |
4 |
