SIR Highlights Need for DVT Awareness on Multiple Levels

March 28, 2011—At its 36th annual scientific meeting in Chicago, the Society of Interventional Radiology (SIR) addressed issues related to deep vein thrombosis (DVT) and its potential to lead to postthrombotic syndrome (PTS), pulmonary embolism (PE), permanent damage to the leg, and even death. March was DVT Awareness Month, and SIR noted that in the United States alone approximately 600,000 people are hospitalized with DVT each year, and more than 100,000 people die of resulting PE.

Leading a session covering several key facets of venous thromboembolism, Suresh Vedantham, MD, spoke of the need to alert medical providers and the general public about DVT's possible causes, symptoms, consequences, and available treatments. He reported that, although the impact of PTS has largely been viewed in relation to adults, prospective studies have shown that children with DVT are also at significant risk for PTS. The recent news of tennis star Serena Williams experiencing a PE shows that even elite athletes can be at risk.

Dr. Vedantham noted that a recent study showed that adolescents with DVT who are treated with clot-removal therapy experienced a very low frequency of PTS. The study by Neil A. Goldenberg, MD, et al was published in the Journal of Vascular and Interventional Radiology (2011;22:121–132). Dr. Vedantham also addressed preventing pediatric PTS in an editorial in the Journal of Vascular and Interventional Radiology (2011;22:405–407) and pointed out that the study of clot-removal treatments was listed as a top research priority in the US Surgeon General's 2008 Call to Action to Prevent DVT and PE.

As part of this effort, the National Institutes of Health has been sponsoring the ATTRACT (Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter-Directed Thrombolysis) study, a $10 million, multicenter randomized trial that is being performed in 50 hospitals nationwide. Dr. Vedantham is the study's lead investigator. ATTRACT seeks to address the public health threat of PTS by determining if image-guided clot-busting treatments can safely prevent PTS and improve long-term quality of life in DVT.

Dr. Vedantham commented, “The interventional radiology community, and particularly the SIR Foundation, helped to develop and continues to strongly support this landmark study, which is midway through its patient enrollment period.”

Additionally, SIR noted that a new study from Washington University in St. Louis, for which Dr. Vedantham served as lead investigator, found that DVT patients with already established PTS that is causing severe long-term leg pain, swelling, or skin ulceration can be successfully treated with image-guided treatments that re-open the blocked veins and eliminate reflux that results from valve damage.

“Significant symptom improvement was observed in 80% of patients who were treated with a combination of stents and endovenous laser ablation,” stated Dr. Vedantham.

“Because established PTS has had no consistently effective treatments, affected patients are generally told that they have to just live with their symptoms, which are often very severe or even disabling,” said Vedantham. “Previous and ongoing research provides hope that a strategy of image-guided treatment may alleviate their symptoms, restore their leg function, and improve their overall quality of life.”