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@article{Staniszewska:2020:10.1016/j.jvsv.2020.02.023,
author = {Staniszewska, A and Onida, S and Lane, T and Davies, AH},
doi = {10.1016/j.jvsv.2020.02.023},
journal = {Journal of vascular surgery. Venous and lymphatic disorders},
pages = {912--918},
title = {The good, bad and the ugly of the acute venous thrombosis: thrombus removal with adjunctive catheter-directed thrombolysis trial from the viewpoint of clinicians},
url = {http://dx.doi.org/10.1016/j.jvsv.2020.02.023},
volume = {8},
year = {2020}
}

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TY  - JOUR
AB  - OBJECTIVE: Acute deep venous thrombosis (DVT) can be complicated by post-thrombotic syndrome, which is associated with significant morbidity and healthcare costs. The Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) was the largest and most controversial randomized controlled trial evaluating the use of pharmacomechanical catheter-directed thrombolysis (CDT) for the prevention of post-thrombotic syndrome after acute DVT. This study aimed to evaluate clinicians' opinion on the ATTRACT trial and its impact on clinical practice. METHODS: An online survey consisting of 10 core multiple choice items and a maximum of five follow-up open-ended questions was delivered to vascular surgeons, interventional radiologists, hematologists, and interventional cardiologists affiliated with 10 international societies between April 23 and July 1, 2019. Clinicians' views on the main limitations of the ATTRACT trial, its impact on patient selection for thrombolysis and the need for a new trial were evaluated. RESULTS: Out of 15,650 contacted clinicians, 451 (3%) completed the survey, with 74% vascular surgeons, 24% interventional radiologists, 2% hematologists, and 0.2% interventional cardiologists. The majority of respondents (79%) were aware of the results of the ATTRACT trial before completing the survey and routinely performed pharmacomechanical CDT (PCDT) in their centers (70%). Only 20% of clinicians considered ATTRACT to be a well-designed and well-performed trial. The inclusion of femoropopliteal DVT was reported as the main limitation of the trial by 55% of respondents. Despite half of the participating clinicians reporting no change in their clinical practice, equal number of clinicians (14%) were encouraged and discouraged from treating iliofemoral DVT. More than one-half of the respondents thought that the use of PCDT would be defensible in a court of law despite the increased risk of bleeding reported in the study. Nearly tw
AU  - Staniszewska,A
AU  - Onida,S
AU  - Lane,T
AU  - Davies,AH
DO  - 10.1016/j.jvsv.2020.02.023
EP  - 918
PY  - 2020///
SN  - 2213-3348
SP  - 912
TI  - The good, bad and the ugly of the acute venous thrombosis: thrombus removal with adjunctive catheter-directed thrombolysis trial from the viewpoint of clinicians
T2  - Journal of vascular surgery. Venous and lymphatic disorders
UR  - http://dx.doi.org/10.1016/j.jvsv.2020.02.023
UR  - https://www.ncbi.nlm.nih.gov/pubmed/32414676
UR  - https://www.sciencedirect.com/science/article/pii/S2213333X20302043?via%3Dihub
UR  - http://hdl.handle.net/10044/1/79669
VL  - 8
ER  -

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