Revolutionizing the treatment of deep vein thrombosis with deep science

By Elise Grant posted 06-20-2017 09:14 AM

Dr. Vedantham

NIH-sponsored ATTRACT Trial finds opportunities to reduce disability and enhance patient safety

By Suresh Vedantham, professor of radiology and surgery, the Mallinckrodt Institute of Radiology, Washington University School of Medicine

The conversation and thinking around how we treat DVT was dramatically changed following presentation of the Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) trial results during SIR 2017.

ATTRACT, for which I was the principal investigator, was a randomized, multicenter, NIH-sponsored study evaluating the effectiveness of the minimally invasive therapy pharmacomechanical catheter-directed thrombolysis (PCDT) in reducing post-thrombotic syndrome (PTS).

The 692 patients in the study were randomly assigned to one of two treatment groups—the active treatment group which received blood-thinning drugs along with PCDT, and a control group that received blood-thinning drugs alone. 

The study’s results included some findings that were entirely expected, and other findings that clearly surprised the audience that was present. The primary study findings illustrate a path to ensuring that DVT patients receive the safest possible initial treatment, and other findings hint at possible distinctions among different subgroups of patients in terms of their response to interventional therapy.    

If integrated effectively, these findings allow health care professionals to make better decisions as to who may benefit from PCDT, ensuring that patient care teams deliver the best care, while reducing harm from unnecessary treatments. Today’s health care environment is focused on delivering the right care for the right patient, and our results support this trend.

However, it can be challenging to effectively incorporate data from pivotal studies into a physician’s clinical decision-making system that has been informed by his/her own clinical experiences and those of trusted colleagues, especially when study findings are unexpected.  The ability to discuss the findings with expert colleagues, and to ask questions that delve more deeply into the study methods and findings, is crucial to formulating a new clinical approach that leverages both kinds of information to maximize benefit to the patient.

This new treatment paradigm will be addressed at SIR’s forthcoming Advanced Therapies in Venous Interventions (ACTIVE) meeting, in Tempe, Ariz. ACTiVE is specifically designed to address the IR’s need for a state-of-the-art approach that is in equal parts data-driven, experience-informed and clinically sensible. Learn more.