Thrombolysis and anticoagulants more effective than anticoagulants alone in acute DVT

Combined thrombolysis and anticoagulation increased the patency of veins and reduced the incidence of post-thrombotic syndrome (PTS) following proximal DVT by one-third. In those receiving combined therapy, there was a small increased risk of bleeding. Three strokes occurred in the treatment group, all in trials conducted pre-1990, and none in the control group. There was no significant effect on mortality at either early (up to 1 month) or intermediate (6 months to 5 years) follow-up. Systemic administration and catheter-directed thrombolysis had similar effectiveness. Trials were carried out principally in the US, Scandinavia, Germany and the UK. All trials included men and women ranging in age from 18 to 75 years, with a preponderance of older adults.