Nav: Home

Temple-led team: Sex-based differences in utilization & outcomes for CDT in DVT patients

March 20, 2017

(Philadelphia, PA) - 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 patients 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, intracranial hemorrhage, gastrointestinal bleeding and acute kidney injury, 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, gastrointestinal bleeding 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."
-end-
About Temple Health

Temple University Health System (TUHS) is a $1.6 billion academic health system dedicated to providing access to quality patient care and supporting excellence in medical education and research. The Health System consists of Temple University Hospital (TUH), ranked among the "Best Hospitals" in the region by U.S. News & World Report; TUH-Episcopal Campus; TUH-Northeastern Campus; Fox Chase Cancer Center, an NCI-designated comprehensive cancer center; Jeanes Hospital, a community-based hospital offering medical, surgical and emergency services; Temple Transport Team, a ground and air-ambulance company; and Temple Physicians, Inc., a network of community-based specialty and primary-care physician practices. TUHS is affiliated with the Lewis Katz School of Medicine at Temple University.

The Lewis Katz School of Medicine (LKSOM), established in 1901, is one of the nation's leading medical schools. Each year, the School of Medicine educates approximately 840 medical students and 140 graduate students. Based on its level of funding from the National Institutes of Health, the Katz School of Medicine is the second-highest ranked medical school in Philadelphia and the third-highest in the Commonwealth of Pennsylvania. According to U.S. News & World Report, LKSOM is among the top 10 most applied-to medical schools in the nation.

Temple Health refers to the health, education and research activities carried out by the affiliates of Temple University Health System (TUHS) and by the Katz School of Medicine. TUHS neither provides nor controls the provision of health care. All health care is provided by its member organizations or independent health care providers affiliated with TUHS member organizations. Each TUHS member organization is owned and operated pursuant to its governing documents.

Temple University Health System

Related Deep Vein Thrombosis Articles:

To the brain, straight from the vein: IV treatment for TBI
A team of researchers from the University of Georgia's Regenerative Bioscience Center has found that neural exosomes -- 'cargo' molecules within the nervous system that carry messages to the brain -- can minimize or even avert progression of traumatic brain injury when used as part of a new cell-to-cell messaging technology.
Deep-CEE: The AI deep learning tool helping astronomers explore deep space
Galaxy clusters are some of the most massive structures in the cosmos, but despite being millions of lightyears across, they can still be hard to spot.
NMR structure of a key anticoagulant protein may help prevent thrombosis
A group of researchers from Brazil and the United States describes for the first time the structure of Ixolaris, an important anticoagulant protein found in tick saliva, and its interaction with Factor Xa, a key enzyme in the process of blood clotting.
Ultrasound for thrombosis prevention
Researchers established real-time ultrasonic monitoring of the blood's aggregate state using the in vitro blood flow model.
Platelet doppelgängers tackle thrombosis and cancer metastasis
Anne-Laure Papa and colleagues have created decoys of platelets -- the body's clot-forming blood cells -- that prevented the formation of dangerous blood clots in vessels (or thrombosis) and combated cancer metastasis in preclinical models.
Technique for preventing extraction of finger vein patterns from photographs
Professor Isao Echizen's group of National Institute of Informatics (NII/Tokyo, Japan) has developed a technique for preventing the extraction of finger vein patterns from photographs.
Newborns face increased risk of thrombosis
Russian scientists have carried out tests to compare the process of blood coagulation in adults and newborns and discovered that the latter face an increased risk of thrombosis.
Study: Immediate compression could help prevent complications after deep-vein thrombosis
People with deep-vein thrombosis (DVT) can substantially cut their risk of potentially debilitating complications by starting adequate compression therapy in the first 24 hours of DVT therapy (known as the acute phase of treatment), suggests a study published today in the journal Blood.
Trial shows chemotherapy is helping kids live with pulmonary vein stenosis
A clinical trial shows that adding chemotherapy to a treatment regimen including catheterization and surgery can deter abnormal cellular growth and finally give children with pulmonary vein stenosis a chance to grow up.
Three-fold higher risk of cancer after acute thrombosis in the leg
The risk of developing cancer is more than three times higher during the first six months following blood clot in the leg, compared with the background population.
More Deep Vein Thrombosis News and Deep Vein Thrombosis Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Reinvention
Change is hard, but it's also an opportunity to discover and reimagine what you thought you knew. From our economy, to music, to even ourselves–this hour TED speakers explore the power of reinvention. Guests include OK Go lead singer Damian Kulash Jr., former college gymnastics coach Valorie Kondos Field, Stockton Mayor Michael Tubbs, and entrepreneur Nick Hanauer.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at Radiolab.org/donate.