Efficacy and safety of catheter-directed thrombolytic therapy of alteplase and urokinase for the treatment of deep vein thrombosis: a Meta-analysis

Objective To systematically review the effectiveness and safety of cathe-ter-directed thrombolytic therapy (CDT) using alteplase and urokinase in the treatment of deep vein thrombosis (DVT) in the lower extremities.Method PubMed, The Cochrane Library, Web of Science, Embase, WanFang Data, CNKI and S...

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Main Authors: Hong-Yan LI, Hai-Shan WANG, Yong-Bo WANG, Xiu-Qing SHI, Si-Yu YAN, Tao WANG
Format: Article
Language:zho
Published: Editorial Office of New Medicine 2023-08-01
Series:Yixue xinzhi zazhi
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Online Access:https://yxxz.whuznhmedj.com/futureApi/storage/attach/2308/qPdLJNenWzyQgnq1if4OpYEyafyvUTBprD6wu5VZ.pdf
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author Hong-Yan LI
Hai-Shan WANG
Yong-Bo WANG
Xiu-Qing SHI
Si-Yu YAN
Tao WANG
author_facet Hong-Yan LI
Hai-Shan WANG
Yong-Bo WANG
Xiu-Qing SHI
Si-Yu YAN
Tao WANG
author_sort Hong-Yan LI
collection DOAJ
description Objective To systematically review the effectiveness and safety of cathe-ter-directed thrombolytic therapy (CDT) using alteplase and urokinase in the treatment of deep vein thrombosis (DVT) in the lower extremities.Method PubMed, The Cochrane Library, Web of Science, Embase, WanFang Data, CNKI and SinoMed databases were searched electronically to collect randomized clinical trials and cohort sudies on CDT using alteplase and urokinase in the treatment of DVT in the lower extremities from inception of the databases to December 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias in included studies, a Meta-analysis was performed using RevMan 5.4 software.Result A total of 7 cohort studies involving 598 patients were included. The results of the Meta-analysis showed that there was no sta-tistically significant difference between alteplase and urokinase in the clinical effectiveness rate [RR=1.07, 95%CI(0.91, 1.25), P=0.43] and thrombolysis rate [RR=1.08, 95%CI(0.99, 1.16), P=0.07]; the thrombolytic time of alteplase was shorter than that of urokinase [MD=-1.12, 95%CI(-1.93, -0.31), P=0.007]; there were no statistically sig-nificant differences between alteplase and urokinase in the incidence of minor bleed-ing[RR=1.19,95%CI(0.70, 2.00), P=0.52] and major bleeding[RR=0.73, 95%CI(0.27, 1.98), P=0.54]. Conclusion The effectiveness and safety of CDT of alteplase and urokinase in the treatment of DVT in the lower extremities and the risk of bleeding are comparable, but alteplase achieved thrombolysis in a shorter time than urokinase. The above conclusions are limited by the quantity and quality of included studies and need to be verified by more high-quality research.
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series Yixue xinzhi zazhi
spelling doaj-art-1036ff5a82d24eb5b91c844b38ac84142024-12-25T10:11:44ZzhoEditorial Office of New MedicineYixue xinzhi zazhi1004-55112023-08-0133426427210.12173/j.issn.1004-5511.2022070356354Efficacy and safety of catheter-directed thrombolytic therapy of alteplase and urokinase for the treatment of deep vein thrombosis: a Meta-analysisHong-Yan LIHai-Shan WANGYong-Bo WANGXiu-Qing SHISi-Yu YANTao WANGObjective To systematically review the effectiveness and safety of cathe-ter-directed thrombolytic therapy (CDT) using alteplase and urokinase in the treatment of deep vein thrombosis (DVT) in the lower extremities.Method PubMed, The Cochrane Library, Web of Science, Embase, WanFang Data, CNKI and SinoMed databases were searched electronically to collect randomized clinical trials and cohort sudies on CDT using alteplase and urokinase in the treatment of DVT in the lower extremities from inception of the databases to December 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias in included studies, a Meta-analysis was performed using RevMan 5.4 software.Result A total of 7 cohort studies involving 598 patients were included. The results of the Meta-analysis showed that there was no sta-tistically significant difference between alteplase and urokinase in the clinical effectiveness rate [RR=1.07, 95%CI(0.91, 1.25), P=0.43] and thrombolysis rate [RR=1.08, 95%CI(0.99, 1.16), P=0.07]; the thrombolytic time of alteplase was shorter than that of urokinase [MD=-1.12, 95%CI(-1.93, -0.31), P=0.007]; there were no statistically sig-nificant differences between alteplase and urokinase in the incidence of minor bleed-ing[RR=1.19,95%CI(0.70, 2.00), P=0.52] and major bleeding[RR=0.73, 95%CI(0.27, 1.98), P=0.54]. Conclusion The effectiveness and safety of CDT of alteplase and urokinase in the treatment of DVT in the lower extremities and the risk of bleeding are comparable, but alteplase achieved thrombolysis in a shorter time than urokinase. The above conclusions are limited by the quantity and quality of included studies and need to be verified by more high-quality research.https://yxxz.whuznhmedj.com/futureApi/storage/attach/2308/qPdLJNenWzyQgnq1if4OpYEyafyvUTBprD6wu5VZ.pdfalteplaseurokinasedeep vein thrombosissystematic reviewme-ta-analysis
spellingShingle Hong-Yan LI
Hai-Shan WANG
Yong-Bo WANG
Xiu-Qing SHI
Si-Yu YAN
Tao WANG
Efficacy and safety of catheter-directed thrombolytic therapy of alteplase and urokinase for the treatment of deep vein thrombosis: a Meta-analysis
Yixue xinzhi zazhi
alteplase
urokinase
deep vein thrombosis
systematic review
me-ta-analysis
title Efficacy and safety of catheter-directed thrombolytic therapy of alteplase and urokinase for the treatment of deep vein thrombosis: a Meta-analysis
title_full Efficacy and safety of catheter-directed thrombolytic therapy of alteplase and urokinase for the treatment of deep vein thrombosis: a Meta-analysis
title_fullStr Efficacy and safety of catheter-directed thrombolytic therapy of alteplase and urokinase for the treatment of deep vein thrombosis: a Meta-analysis
title_full_unstemmed Efficacy and safety of catheter-directed thrombolytic therapy of alteplase and urokinase for the treatment of deep vein thrombosis: a Meta-analysis
title_short Efficacy and safety of catheter-directed thrombolytic therapy of alteplase and urokinase for the treatment of deep vein thrombosis: a Meta-analysis
title_sort efficacy and safety of catheter directed thrombolytic therapy of alteplase and urokinase for the treatment of deep vein thrombosis a meta analysis
topic alteplase
urokinase
deep vein thrombosis
systematic review
me-ta-analysis
url https://yxxz.whuznhmedj.com/futureApi/storage/attach/2308/qPdLJNenWzyQgnq1if4OpYEyafyvUTBprD6wu5VZ.pdf
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