VIVA 2019: Open vein hypothesis has “validity” for DVT patients, but other factors at play as well


Suresh Vedantham (St Louis, USA) talks to BLearning Venous after winning the prestigious VEINS award at VIVA 2019 (Vascular InterVentional Advances; 4–7 November, Las Vegas, USA) about his current take on the open vein hypothesis and more.

Vedantham reflects on the recent major developments in the treatment of patients with acute iliofemoral deep vein thrombosis (DVT), noting that “we are now lucky to have data from large clinical trials”, including DUTCH CAVA and ATTRACT [to help guide treatment decisions]. Vedantham draws out the similarities in findings from these two trials for this particular sub-group of patients, and points out that the addition of device-assisted, pharmacological thrombolysis did not result in a benefit in post-thrombotic syndrome (PTS) prevention.

On the other hand, he noted, the ATTRACT trial subgroup analyses have, for the first time, provided high-quality randomised trial data to substantiate the existence of worthwhile benefits in terms of symptom relief and quality of life improvement in patients with acute iliofemoral DVT.

Vedantham explains that he emphasises the “short-term” benefits of thrombolytic therapy to particularly symptomatic DVT patients who are being offered this treatment and concludes that physicians still need more research to discern to “a much higher degree” which patients will benefit the most from it.


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