Evidence map›Paper›PMID 40421786›Full record

SynthesisAnnals of surgery2026

A Systematic Review and Meta-analysis of the Efficacy and Safety of Lytic and Non-lytic Early Thrombus Removal Technologies for Iliofemoral Deep Vein Thrombosis.

Benedict R H Turner, Sara Jasionowska, Jessica Shea, Avik Ghosh, Matthew Machin, Adam M Gwozdz, Stephen A Black, Alun H Davies

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Benedict R H TurnerSection of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
Sara JasionowskaSection of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
Jessica SheaDepartment of Orthopaedic Surgery, Kingston Hospitals NHS Foundation Trust, Kingston Upon Thames, UK.
Avik GhoshSection of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
Matthew MachinSection of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
Adam M GwozdzSection of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.ORCID 0000-0002-5913-2273
Stephen A BlackAcademic Department of Vascular Surgery, St Thomas's Hospital, King's College London, London, UK.
Alun H DaviesSection of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis systematic review and meta-analysis compared the effectiveness and safety of lytic and non-lytic early thrombus removal strategies in addition to anticoagulation versus anticoagulation alone.

backgroundEarly thrombus removal strategies have been developed to prevent post-thrombotic syndrome (PTS) following acute iliofemoral deep vein thrombosis (DVT).

methodsThis review followed PRISMA guidelines using a registered protocol (CRD42023437158). The MEDLINE and Embase databases, as well as trial registries, were searched without limitations. Head-to-head or single-armed trials or studies that reported the rate of PTS in patients with iliofemoral DVT (symptomatic for <28 days) and early thrombus removal were included. The rates of PTS, moderate-severe PTS, major bleeding, risk-benefit ratio, DVT recurrence, and mortality were pooled in meta-analysis with fixed or random effects.

resultsAcross all study designs (20 studies), the rate of PTS was 24.5% (95% CI: 19.5-30.3%) for lytic therapies, 18.8% (1 study) for non-lytic therapy, and 40.4% (95% CI: 35.3-45.7) for anticoagulation alone. The number needed to treat was 6 for PTS and 15 for moderate-severe PTS. In randomized trials, the odds of major bleeding with lytic therapies were 4.9 (95% CI: 1.3-19.1) compared with anticoagulation; the number needed to harm was 33. There was no major bleeding for mechanical thrombectomy.

conclusionsEarly thrombus removal reduces PTS and moderate-severe PTS, while increasing nonfatal major bleeding. Mechanical thrombectomy removes major bleeding risk, but efficacy evidence is limited to 1 observational study.

Indexed as

Femoral VeinIliac VeinPostthrombotic SyndromeThrombectomyVenous ThrombosisAnticoagulantsHumansTreatment OutcomeAnticoagulantsanticoagulationcatheter directed thrombolysisdeep vein thrombosisiliofemoralmechanical thrombectomypharmacomechanical thrombectomypost-thrombotic syndromepulmonary embolismvenous thromboembolism

Identifiers

PMID40421786
PMCPMC12783348

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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.