Stenting no better than medical management in lowering VTE and mortality in acute DVT patients
A systematic review and meta-analysis entitled "Stenting or angioplasty for the treatment of deep vein thrombosis: Systematic review and meta-analysis of randomized controlled trials” by Flumignan et al. and team has concluded that stenting or angioplasty or SA results in little to no difference in post-thrombotic syndrome or PTS, venous thromboembolism or VTE and mortality in acute deep vein thrombosis or DVT compared to Best medical practice. The evidence regarding SA in chronic DVT and whether SA, compared to BMP and thrombolysis, decreases PTS and VTE in acute DVT is uncertain, they said.
Explaining the research background, researchers said that anticoagulation is the main treatment for DVT. In particular patients, researchers perform SA. We assessed the effects of SA by conducting a systematic review of RCTs.
They researched Cochrane CENTRAL, MEDLINE, Embase, CINAHL, LILACS, IBECS databases, and trial registries. The primary outcomes measured in the study were PTS, VTE and all-cause mortality.
The key results of the study are:
- 7 RCTs were included and had 1485 participants.
- The researchers found no clinically significant difference between SA and BMP for the additional treatment of acute DVT regarding PTS with a standardized mean difference of −7.87, and VTE and no deaths.
- Compared to BMP, the SA plus BMP and thrombolysis results in little to no difference in PTS with a mean difference of −1.07, VTE with an RR of 1.48 and mortality with an RR of 0.92.
- There was no clinical difference between stenting and BMP for chronic DVT regarding PTS and no VTE and death events.
Concluding further, they said, “We found that stenting or angioplasty was associated with little to no difference effects in PTS, VTE, major bleeding, death, secondary patency or QoL with a follow-up 12 to 36 months; and with very low to moderate certainty evidence.”
According to them, they included all relevant studies.
The team is thankful to Cochrane Brazil and the Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo, Brazil, for their support.
Further reading:
Flumignan, Ronald Luiz Gomes MD, MBA, PhDa,b,*; Civile, Vinicius Tassoni PhDb; Areias, Libnah Leal MDa; Flumignan, Carolina Dutra Queiroz MD, PhDb,c; Amorim, Jorge Eduardo MD, PhDa; Lopes, Renato Delascio MD, PhDd; Nakano, Luis C. U. MD, MBA, PhDa,b; Baptista-Silva, Jose Carlos Costa MD, PhDa,b. Stenting or angioplasty for the treatment of deep vein thrombosis: Systematic review and meta-analysis of randomized controlled trials. Medicine 102(22):p e33924, June 02, 2023. | DOI: 10.1097/MD.0000000000033924
