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Dear Sir, In my opinion -Why ATTRACT clinical trials on IR m/m of Acute DVT Failed?
a)Pharmaco-mechanical thrombolysis done with devices mostly used in treating Arterial thrombosis.
Since clot burden in ‘Venous disease’ is MORE.These devices failed to generate successful thrombolysis results.
More “Dedicated Angiojet Zelante Thrombectomy Device” should have been used.
b)Risk-benefits ratio of lysing ilio-femoral DVT Vs Femoral DVT Not taken into account.
c) Response of thrombus at different Anatomical levels not considered.
d) Surprisingly CANCER patients and Malignancy induced DVT Excluded from trial.
e) Inj.Reteplase(rt-PA) should have been used instead of Inj.Alteplase. Also Inj.Urokinase with Heparin combination works well. .
Let me know other Consultant Drs opinion on this burning & hot debated issue of ATTARACT Trial?
With best wishes & Rgds!
Consultant Phlebologist & Interventional Radiologist