What is CaVenT study?

Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial.

209 patients were randomly assigned to treatment groups (108 control, 101 CDT). At completion of 24 months' follow-up, data for clinical status were available for 189 patients (90%; 99 control, 90 CDT). At 24 months, 37 (41·1%, 95% CI 31·5—51·4) patients allocated additional CDT presented with PTS compared with 55 (55·6%, 95% CI 45·7—65·0) in the control group (p=0·047). The difference in PTS corresponds to an absolute risk reduction of 14·4% (95% CI 0·2—27·9), and the number needed to treat was 7 (95% CI 4—502). Iliofemoral patency after 6 months was reported in 58 patients (65·9%, 95% CI 55·5—75·0) on CDT versus 45 (47·4%, 37·6—57·3) on control (p=0·012). 20 bleeding complications related to CDT included three major and five clinically relevant bleeds.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61753-4/abstract

from University of Oslo.

Longterm outcomes after catheter directed thrombolysis in DVT

What is CaVenT study?

Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. 209 patients were randomly assigned to treatment groups (108 control, 101 CDT). At completion of 24 months' follow-up, data for clinical status were available for 189 patients (90%; 99 control, 90 CDT). At 24 months, 37 (41·1%, 95% CI 31·5—51·4) patients allocated additional CDT presented with PTS compared with 55 (55·6%, 95% CI 45·7—65·0) in the control group (p=0·047). The difference in PTS corresponds to an absolute risk reduction of 14·4% (95% CI 0·2—27·9), and the number needed to treat was 7 (95% CI 4—502). Iliofemoral patency after 6 months was reported in 58 patients (65·9%, 95% CI 55·5—75·0) on CDT versus 45 (47·4%, 37·6—57·3) on control (p=0·012). 20 bleeding complications related to CDT included three major and five clinically relevant bleeds.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61753-4/abstract

from University of Oslo.

Transplantation of an allogeneic vein bioengineered with autologous stem cells

Vein segments are harvested and used for bypassing the arterial occlusions and these vein grafts have good long term patency. But when a vein has to be bypassed then we do not have an ideal graft available to us. In the recent past a 9 cm segment of allogeneic donor iliac vein was decellularised and subsequently recellularised with endothelial and smooth muscle cells differentiated from stem cells obtained from the bone marrow of the recipient. Such a graft may not require suppression for life time by sweedish team of doctors.

After one year a second stem-cell populated vein graft was used for relieving the compression of first graft graft and  to lengthen the previous graft which was used for replacing the portal vein in a patient with extra hepatic portal vein obstruction. With restored portal circulation the patient has substantially improved physical and mental function and growth. The patient has no anti-endothelial cell antibodies and is receiving no immunosuppressive drugs. An acellularised deceased donor vein graft recellularised with autologous stem cells can be considered for patients in need of vascular vein shunts without the need for immunosuppression.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60633-3/fulltext#article_upsell