If you as a health care professional are involved in the management of patients with acute (proximal) DVT, please consider giving the patient (who has leg symptoms ≤ 14 days) an opportunity to be enrolled in the national ATTRACT trial (information on the trial is here).
This NIH-funded, multi-center trial investigates whether catheter-directed thrombectomy (± locally delivered tPA into the clot) is beneficial in preventing post-thrombotic syndrome. Patients are randomized 1:1 into either receiving catheter-directed thrombectomy or not, followed in either case by routine anticoagulation. Main outcome measure is the development of postthrombotic syndrome.
Even though some vascular surgery / vascular medicine / vascular radiology practices have adopted catheter-directed thrombectomy as an almost routine practice, it is not known as of 2011 whether the procedure is beneficial, when one weighs the risk/benefit of bleeding and prevention of postthrombotic syndrome. Thus, the NIH’s interest in and support for this clinically relevant DVT study.
There are presently 45 sites enrolling patients into this trial (list of sites is here). This is not a very time-intense trial for the patient, so if the patient lives within 3-4 hours of such an ATTRACT site, I think it is worthwhile to consider participation. You as the treating health care professional do not have to be a direct part of the ATTRACT network and do not need to have IRB (institutional review board) approval – your patient’s participation can still be arranged. My suggestion, if you allow: (a) you can mention the study to your patient and print our this ClotConnect blog entry and give it to your patient so that he/she can find and contact a site near him/her, and see whether he/she wants to participate, or (b) you can contact the ATTRACT site nearest to you (list of sites is here) and talk about the study and how to get your patient enrolled.
Please help spread the word about the trial to all patients with acute proximal DVT. Thank you very much.
This same blog information, written for patients, can be found here.
Disclosure: I have no financial conflict of interest with this blog post. However, I am an investigator for the trial at the University of North Carolina, Chapel Hill, NC.
Last updated: Feb 25th, 2011
Tags: Angiojet, catheter-directed, Deep vein thrombosis, DVT, Embolectomy, fibrinolytic therapy, Post-thrombotic syndrome, study, thrombectomy, thrombolytic therapy, Tissue plasminogen activator, tPA, Trellis, trial