Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
Pediatric Radiology
Erschienen in: Pediatric Radiology 5/2015

01.05.2015 | Original Article

Outcomes in children with deep vein thrombosis managed with percutaneous endovascular thrombolysis

verfasst von: Christopher E. Dandoy, Kamlesh U. Kukreja, Ralph A. Gruppo, Manish N. Patel, Cristina Tarango

Erschienen in: Pediatric Radiology | Ausgabe 5/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

Our center has developed a multidisciplinary approach to percutaneous endovascular thrombolysis with the goal of improving outcomes in children with thrombosis. There is little data describing the safety and efficacy of endovascular thrombolysis and the frequency of post-thrombotic syndrome after thrombolysis in children.

Objective

Retrospective analysis of children undergoing percutaneous endovascular thrombolysis to determine (1) the safety and efficacy of this procedure and (2) the frequency of the diagnosis of post-thrombotic syndrome after thrombolysis.

Materials and methods

We reviewed the medical and imaging databases for children who underwent percutaneous endovascular thrombolysis for deep venous thrombosis (DVT) between November 2008 and June 2013 at our institution. Demographic data were reviewed for the technical success and complications of thrombolysis and the last assigned post-thrombotic syndrome score using standardized scoring tools.

Results

Forty-one children ages 3 months to 21 years (median age: 15 years; 44% male) underwent percutaneous endovascular thrombolysis between November 2008 and June 2013. Upper extremity DVT occurred in 13 patients (32%); lower extremity DVT occurred in 28 patients (68%). All 41 patients received thrombolysis grading; 90% of those patients achieved greater than 50% thrombus lysis. Twenty-eight patients received formal post-thrombotic syndrome scoring and 4 (14%) met diagnostic criteria for post-thrombotic syndrome. One major bleeding episode and one pulmonary embolism occurred with no long-term sequelae.

Conclusion

Endovascular thrombolysis for DVT in children is safe, effective at thrombus removal and may reduce the incidence of post-thrombotic syndrome. Randomized or larger clinical trials would be needed to determine the long-term benefits of endovascular thrombolysis.
Literatur
1.
Kukreja K, Gruppo R, Chima R et al (2013) Developing a pediatric endovascular thrombolysis program: a single-center experience. Pediatr Radiol 43:1024–1029CrossRefPubMed
2.
Parasuraman S, Goldhaber SZ (2006) Venous thromboembolism in children. Circulation 113:e12–e16CrossRefPubMed
3.
Raffini L, Huang Y-S, Witmer C et al (2009) Dramatic increase in venous thromboembolism in children’s hospitals in the United States from 2001 to 2007. Pediatrics 124:1001–1008CrossRefPubMed
4.
Chan AKC, Monagle P (2012) Updates in thrombosis in pediatrics: where are we after 20 years? ASH Educ Prog Book 2012:439–443
5.
Prandoni P, Lensing AWA, Cogo A et al (1996) The long-term clinical course of acute deep venous thrombosis. Ann Intern Med 125:1–7CrossRefPubMed
6.
Goldenberg NA, Donadini MP, Kahn SR et al (2010) Post-thrombotic syndrome in children: a systematic review of frequency of occurrence, validity of outcome measures, and prognostic factors. Haematologica 95:1952–1959CrossRefPubMedCentralPubMed
7.
8.
9.
Pianta MJ, Thomson KR (2011) Catheter-directed thrombolysis of lower limb thrombosis. Cardiovasc Intervent Radiol 34:25–36CrossRefPubMed
10.
Goldenberg NA, Branchford B, Wang M et al (2011) Percutaneous mechanical and pharmacomechanical thrombolysis for occlusive deep vein thrombosis of the proximal limb in adolescent subjects: findings from an institution-based prospective inception cohort study of pediatric venous thromboembolism. J Vasc Interv Radiol 22:121–132CrossRefPubMedCentralPubMed
11.
Darbari DS, Desai D, Arnaldez F et al (2012) Safety and efficacy of catheter directed thrombolysis in children with deep venous thrombosis. Brit J Haematol 159:376–378CrossRef
12.
Enden T, Haig Y, Kløw N-E et al (2012) Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet 379:31–38CrossRefPubMed
13.
Stain M, Schönauer V, Minar E et al (2005) The post-thrombotic syndrome: risk factors and impact on the course of thrombotic disease. J Thromb Haemost 3:2671–2676CrossRefPubMed
14.
Leary SE, Harrod VL, de Alarcon PA et al (2010) Low-dose systemic thrombolitic therapy for deep vein thrombosis in pediatric patients. J Pediatr Hematol Oncol 32:97–102CrossRefPubMedCentralPubMed
15.
Goldenberg NA, Durham JD, Knapp-Clevenger R et al (2007) A thrombolytic regimen for high-risk deep venous thrombosis may substantially reduce the risk of postthrombotic syndrome in children. Blood 110:45–53CrossRefPubMedCentralPubMed
16.
Mewissen MW, Seabrook GR, Meissner MH et al (1999) Catheter-directed thrombolysis for lower extremity deep venous thrombosis: report of a national multicenter registry. Radiology 211:39–49CrossRefPubMed
17.
Mitchell LG, Goldenberg NA, Male C et al (2011) Definition of clinical efficacy and safety outcomes for clinical trials in deep venous thrombosis and pulmonary embolism in children. J Thromb Haemost 9:1856–1858CrossRefPubMed
18.
Kearon C, Akl EA, Comerota AJ et al (2012) Antithrombotic therapy for VTE disease: Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 141:e419S–94SCrossRefPubMedCentralPubMed
19.
Vedantham S, Vesely TM, Parti N et al (2002) Lower extremity venous thrombolysis with adjunctive mechanical thrombectomy. J Vasc Interv Radiol 13:1001–1008CrossRefPubMed
20.
Vedantham S, Thorpe PE, Cardella JF et al (2006) Quality improvement guidelines for the treatment of lower extremity deep vein thrombosis with use of endovascular thrombus removal. J Vasc Interv Radiol 17:435–447CrossRefPubMed
21.
Kahn SR (2009) Measurement properties of the Villalta scale to define and classify the severity of the post-thrombotic syndrome. J Thromb Haemost 7:884–888CrossRefPubMed
22.
Goldenberg NA, Brandão LR, Journeycake J et al (2012) Definition of post-thrombotic syndrome following lower extremity deep venous thrombosis and standardization of outcome measurement in pediatric clinical investigations. J Thromb Haemost 10:477–480CrossRefPubMed
23.
Villalta S, Bagatella P, Piccioli A et al. (1994) Assessment of validity and reproducibility of a clinical scale for the post-thrombotic syndrome. Haemostasis 24:158A (abstract)
24.
Vedantham S, Thorpe PE, Cardella JF et al (2009) Quality improvement guidelines for the treatment of lower extremity deep vein thrombosis with use of endovascular thrombus removal. J Vasc Interv Radiol 20:S227–S239CrossRefPubMed
25.
Bjarnason H, Kruse JR, Asinger DA et al (1997) Iliofemoral deep venous thrombosis: safety and efficacy outcome during 5 years of catheter-directed thrombolytic therapy. J Vasc Interv Radiol 8:405–418CrossRefPubMed
26.
Leaker M, Massicotte MP, Brooker LA et al (1996) Thrombolytic therapy in pediatric patients: a comprehensive review of the literature. Thromb Haemost 76:132–134PubMed
27.
28.
Newall F, Browne M, Savoia H et al (2007) Assessing the outcome of systemic tissue plasminogen activator for the management of venous and arterial thrombosis in pediatrics. J Pediatr Hematol Oncol 29:269–273CrossRefPubMed
29.
Gupta AA, Leaker M, Andrew M et al (2001) Safety and outcomes of thrombolysis with tissue plasminogen activator for treatment of intravascular thrombosis in children. J Pediatr 139:682–688CrossRefPubMed
30.
Monagle P, Chan AKC, Goldenberg NA et al (2012) Antithrombotic therapy in neonates and children: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-based Clinical Practice Guidelines. Chest 141:e737S–e801SCrossRefPubMedCentralPubMed
31.
Kahn SR, Shbaklo H, Lamping DL et al (2008) Determinants of health-related quality of life during the 2 years following deep vein thrombosis. J Thromb Haemost 6:1105–1112CrossRefPubMed
32.
Kahn SR, Ducruet T, Lamping DL et al (2005) Prospective evaluation of health-related quality of life in patients with deep venous thrombosis. Arch Intern Med 165:1173–1178CrossRefPubMed
33.
Broholm R, Sillesen H, Damsgaard MT et al (2011) Postthrombotic syndrome and quality of life in patients with iliofemoral venous thrombosis treated with catheter-directed thrombolysis. J Vasc Surg 54:18S–25SCrossRefPubMed
Metadaten
Titel
Outcomes in children with deep vein thrombosis managed with percutaneous endovascular thrombolysis
verfasst von
Christopher E. Dandoy
Kamlesh U. Kukreja
Ralph A. Gruppo
Manish N. Patel
Cristina Tarango
Publikationsdatum
01.05.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Radiology / Ausgabe 5/2015
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-014-3209-4

Weitere Artikel der Ausgabe 5/2015

Pediatric Radiology 5/2015 Zur Ausgabe

Original Article

Utility of CT-compatible EEG electrodes in critically ill children

Fellow Rounds

Case 2: a 10-year-old girl with hip pain

Case Report

Spondyloepimetaphyseal dysplasia with joint laxity, leptodactylic type: longitudinal observation of radiographic findings in a child heterozygous for a KIF22 mutation

Original Article

Pediatric cardiac MRI: automated left-ventricular volumes and function analysis and effects of manual adjustments

PEDIATRIC RADIOLOGY CME ACTIVITY

Pediatric Radiology Continuing Medical Education Activity

Letter to the Editor

Mind the gap: extent of use of diffusion-weighted MRI in children with rhabdomyosarcoma

Neu im Fachgebiet Radiologie

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise