Clinical and economic evaluation of the Trellis-8 infusion catheter for deep vein thrombosis

J Vasc Interv Radiol. 2008 Mar;19(3):377-83. doi: 10.1016/j.jvir.2007.10.027.

Abstract

Purpose: To summarize the preliminary experience with the Trellis-8 infusion catheter (TIC) in the treatment of deep venous thrombosis (DVT) and compare the outcome to that with catheter-directed thrombolysis (CDT) by using a meta-analysis of published reports.

Materials and methods: Technical success, bleeding complications, and costs for patients treated with the TIC for DVT were reported through a voluntary, company-sponsored registry. Technical success was classified by using the National Venous Registry grading scale for DVT lysis (<50% lysis = grade I, 50%-99% lysis = grade II, and 100% lysis = grade III). The cost of treatment with the TIC was based on equipment (catheters) needed to perform the intervention, thrombolytic agents used, bleeding episodes, procedure time in the angiography and/or interventional suite, and monitoring time in a critical care unit. Outcomes with the TIC were compared against outcomes with CDT by using literature-derived outcomes derived from a meta-analysis.

Results: Thrombolytic doses and infusion durations were less with TIC than with conventional CDT. Grade II and III lysis was achieved in 93% of patients treated with the TIC and 79% of patients treated with CDT (P = .03). Major hemorrhage was reported in none of the TIC patients and in 8.5% of patients treated with CDT (P < .001). The per-patient cost of therapy was $3,697 for TIC and $5,473 for CDT (P = .03).

Conclusions: Thrombolysis in DVT with the TIC is associated with a greater technical success rate, a lower rate of bleeding, and a lower cost than that reported for CDT. These preliminary results indicate that further evaluation of the TIC in the treatment of DVT is warranted.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Catheterization* / economics
  • Female
  • Fibrinolytic Agents / administration & dosage
  • Humans
  • Male
  • Middle Aged
  • Recombinant Proteins / administration & dosage
  • Tenecteplase
  • Thrombolytic Therapy / economics
  • Thrombolytic Therapy / instrumentation*
  • Tissue Plasminogen Activator / administration & dosage
  • Treatment Outcome
  • Urokinase-Type Plasminogen Activator / administration & dosage
  • Venous Thrombosis / drug therapy*

Substances

  • Fibrinolytic Agents
  • Recombinant Proteins
  • reteplase
  • Tissue Plasminogen Activator
  • Urokinase-Type Plasminogen Activator
  • Tenecteplase