Evidence map›Paper›PMID 30586751›Full record

Trial reportCirculation2019

Endovascular Thrombus Removal for Acute Iliofemoral Deep Vein Thrombosis.

Anthony J Comerota, Clive Kearon, Chu-Shu Gu, Jim A Julian, Samuel Z Goldhaber, Susan R Kahn, Michael R Jaff, Mahmood K Razavi, Andrei L Kindzelski, Riyaz Bashir and 9 more

4 registry-linked trialsOpen access · bronzeAbstract readClinical Trial, Phase IIIMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 91 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 9 pooled it
29.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00790335 phase3completednot on this map

Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter-Directed Thrombolysis--The ATTRACT Trial

TypeinterventionalSponsorWashington University School of MedicineRan2009 to 2017Enrolled692ConditionsDeep Vein Thrombosis, Venous Thrombosis, Postphlebitic Syndrome, Venous ThromboembolismArmsRecombinant tissue plasminogen activator (rt-PA)
NCT04694248 narecruitingnot on this mapstarted 2021, after this paper: background citation

Anticoagulant Plus Antiplatelet Therapy Following Iliac Vein Stenting

TypeinterventionalSponsorFirst Affiliated Hospital of Zhejiang UniversityRan2021 to 2027Enrolled172ConditionsDeep Vein Thrombosis, Iliac Vein Thrombosis, Iliac Vein Obstruction, Iliac Vein StenosisArmsRivaroxaban, Aspirin
NCT05827120 completednot on this mapstarted 2021, after this paper: background citation

Long-term Effect of Different Modes of Endovascular Therapy in Combination With Anticoagulation Treatment in Patients With Acute Extensive Deep Vein Thrombosis (LEVANTE Research)

TypeobservationalSponsorNational Institute of Cardiovascular Diseases, SlovakiaRan2021 to 2023Enrolled110ConditionsAcute Deep Venous ThrombosisArmsMechanical / pharmacomechanical thrombectomy plus local catheter directed thrombolysis, Local catheter directed thrombolysis alone
NCT06486181 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

A Randomized Controlled Trial for Second Line Treatment of Acute DVT With Endovascular Interventional Treatments

TypeinterventionalSponsorRush University Medical CenterRan2026 to 2029Enrolled100ConditionsDeep Venous ThrombosisArmsThrombolysis/Thrombectomy
3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 9 syntheses or guidelines pooled it, 306 citations in OpenAlex.

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  3. Angioplasty or stenting for deep venous thrombosis.The Cochrane database of systematic reviews · 2025
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31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 16 institutions in 2 countries.

Anthony J ComerotaInova Heart and Vascular Institute, Inova Alexandria Hospital, VA (A.J.C.).
Clive KearonThrombosis and Atherosclerosis Research Institute (C.K.), McMaster University, Hamilton, ON, Canada.
Chu-Shu GuDepartment of Oncology (C.-S.G., J.A.J.), McMaster University, Hamilton, ON, Canada.
Jim A JulianDepartment of Oncology (C.-S.G., J.A.J.), McMaster University, Hamilton, ON, Canada.
Samuel Z GoldhaberDivision of Cardiovascular Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (S.Z.G.).
Susan R KahnJewish General Hospital, Lady Davis Institute, Center for Clinical Epidemiology, Montreal, QC, Canada (S.R.K.).
Michael R JaffNewton-Wellesley Hospital, and Harvard Medical School, Boston, MA (M.R.J.).
Mahmood K RazaviSt. Joseph's Hospital, Orange, CA (M.K.R.).
Andrei L KindzelskiNational Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (A.L.K.).
Riyaz BashirDepartment of Medicine, Temple University Hospital, Philadelphia, PA (R.B.).
Parag PatelDepartment of Radiology, Medical College of Wisconsin, Milwaukee (P.P.).
Mel SharafuddinDivision of Vascular Surgery, University of Iowa, Iowa City (M.S.).
Michael J SichlauVascular and Interventional Professionals LLC, Hinsdale, IL (M.J.S.).
Wael E SaadDepartment of Radiology, University of Michigan, Ann Arbor (W.E.S.).
Zakaria AssiToledo Radiological Associates, Vascular & Interventional Radiology, OH (Z.A.).
Lawrence V HofmannDepartment of Radiology, Stanford University, CA (L.V.H.).
Margaret KennedyDepartment of Medicine, Duke University, Durham, NC (M.K.).
Suresh VedanthamMallinckrodt Institute of Radiology, Washington University in St. Louis, MO (S.V.).
ATTRACT Trial Investigators
Juravinski Cancer Centre · CASociety of Interventional Radiology · USBrigham and Women's Hospital · USDuke University · USInova Alexandria Hospital · USJewish General Hospital · CAJuravinski Hospital · CAMallinckrodt (United States) · USMedical College of Wisconsin · USNational Heart Lung and Blood Institute · USNewton Wellesley Hospital · USStanford University · USSt. Joseph Hospital · USTemple University Hospital · USUniversity of Iowa · USUniversity of Michigan · US

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
Washington University Institute of Clinical and Translational SciencesUL1TR000448 · NCATS · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2012 to 2016
$41.4M
Translational Research Skills Development CoreU54HL112303 · NHLBI · WASHINGTON UNIVERSITY · PI SADLER, J EVAN · 2012 to 2016
$8.8M
PHARMACOMECHANICAL CATHETER-DIRECTED THROMBOLYSIS FOR ACUTE DVT - ATTRACT TRIALU01HL088476 · NHLBI · WASHINGTON UNIVERSITY · PI VEDANTHAM, SURESH · 2008 to 2013
$7.2M
Data Coordinating Centre for ATTRACT TrialU01HL088118 · NHLBI · MCMASTER UNIVERSITY · PI KEARON, CLIVE · 2008 to 2012
$2.9M
CIHRNCATS NIH HHS UL1 TR000448NCATS NIH HHS UL1 TR002345NHLBI NIH HHS U01 HL088118NHLBI NIH HHS U01 HL088476NHLBI NIH HHS U54 HL112303
6 · The paper itself

Abstract

backgroundThe ATTRACT trial (Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis) previously reported that pharmacomechanical catheter-directed thrombolysis (PCDT) did not prevent postthrombotic syndrome (PTS) in patients with acute proximal deep vein thrombosis. In the current analysis, we examine the effect of PCDT in ATTRACT patients with iliofemoral deep vein thrombosis.

methodsWithin a large multicenter randomized trial, 391 patients with acute deep vein thrombosis involving the iliac or common femoral veins were randomized to PCDT with anticoagulation versus anticoagulation alone (No-PCDT) and were followed for 24 months to compare short-term and long-term outcomes.

resultsBetween 6 and 24 months, there was no difference in the occurrence of PTS (Villalta scale ≥5 or ulcer: 49% PCDT versus 51% No-PCDT; risk ratio, 0.95; 95% CI, 0.78-1.15; P=0.59). PCDT led to reduced PTS severity as shown by lower mean Villalta and Venous Clinical Severity Scores ( P<0.01 for comparisons at 6, 12, 18, and 24 months), and fewer patients with moderate-or-severe PTS (Villalta scale ≥10 or ulcer: 18% versus 28%; risk ratio, 0.65; 95% CI, 0.45-0.94; P=0.021) or severe PTS (Villalta scale ≥15 or ulcer: 8.7% versus 15%; risk ratio, 0.57; 95% CI, 0.32-1.01; P=0.048; and Venous Clinical Severity Score ≥8: 6.6% versus 14%; risk ratio, 0.46; 95% CI, 0.24-0.87; P=0.013). From baseline, PCDT led to greater reduction in leg pain and swelling ( P<0.01 for comparisons at 10 and 30 days) and greater improvement in venous disease-specific quality of life (Venous Insufficiency Epidemiological and Economic Study Quality of Life unit difference 5.6 through 24 months, P=0.029), but no difference in generic quality of life ( P>0.2 for comparisons of SF-36 mental and physical component summary scores through 24 months). In patients having PCDT versus No-PCDT, major bleeding within 10 days occurred in 1.5% versus 0.5% ( P=0.32), and recurrent venous thromboembolism over 24 months was observed in 13% versus 9.2% ( P=0.21).

conclusionsIn patients with acute iliofemoral deep vein thrombosis, PCDT did not influence the occurrence of PTS or recurrent venous thromboembolism. However, PCDT significantly reduced early leg symptoms and, over 24 months, reduced PTS severity scores, reduced the proportion of patients who developed moderate-or-severe PTS, and resulted in greater improvement in venous disease-specific quality of life. CLINICAL

trial registrationURL: https://www.clinicaltrials.gov . Unique identifier: NCT00790335.

Indexed as

Acute DiseaseAdultAnticoagulantsEndovascular ProceduresFemaleFemoral VeinHumansIliac VeinMaleMechanical ThrombolysisMiddle AgedPostthrombotic SyndromeAnticoagulantsdeep vein thrombosispostthrombotic syndromethrombolysis, therapeutic

Identifiers

PMID30586751
PMCPMC6389417
OpenAlexW2916384180

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.