{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:38:26Z","timestamp":1790815106615,"version":"4.1.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The CAVA (Ultrasound\u2010Accelerated Catheter\u2010Directed Thrombolysis Versus Anticoagulation for the Prevention of Post\u2010Thrombotic Syndrome) trial did not show a reduction of post\u2010thrombotic syndrome (PTS) after additional ultrasound\u2010accelerated catheter\u2010directed thrombolysis in patients with acute iliofemoral deep vein thrombosis at 1\u2010year follow\u2010up. This prespecified analysis of the CAVA trial aimed to determine the impact of additional thrombolysis on outcomes of PTS at long\u2010term follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Patients aged 18 to 85\u00a0years with a first\u2010time acute iliofemoral deep vein thrombosis were included and randomly assigned (1:1) to either standard treatment plus ultrasound\u2010accelerated catheter\u2010directed thrombolysis or standard treatment alone. The primary outcome was the proportion of PTS (Villalta score \u22655 on 2 occasions \u22653\u00a0months apart or venous ulceration) at the final follow\u2010up visit. Additionally, PTS according to the International Society on Thrombosis and Haemostasis (ISTH) consensus definition was assessed to allow external comparability. Major bleedings were the main safety outcome. At a median follow\u2010up of 39.0\u00a0months (interquartile range, 23.3\u201363.8), 120 patients (79.8%) participated in the final follow\u2010up visit: 62 from the intervention group and 58 from the standard treatment group. PTS developed in 19 (30.6%) versus 26 (44.8%) patients, respectively (odds ratio [OR], 0.54; 95% CI, 0.26 to 1.15 [\n                      <jats:italic>P<\/jats:italic>\n                      =0.11]), with an absolute difference between groups of \u221214.2% (95% CI, \u221232.0% to 4.8%). Using the ISTH consensus definition, a significant reduction in PTS was observed (29 [46.8%] versus 40 [69.0%]) (OR, 0.40; 95% CI, 0.19\u20130.84 [\n                      <jats:italic>P<\/jats:italic>\n                      =0.01]) with an absolute difference between groups of \u221222.2% (95% CI, \u221239.8% to \u22122.8%). No new major bleedings occurred following the 12\u2010month follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The impact of additional ultrasound\u2010accelerated catheter\u2010directed thrombolysis on the prevention of PTS was found to increase with time. Although this study was limited by its sample size, the overall findings indicate a reduction of mild PTS without impact on quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT00970619.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.018973","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T05:23:51Z","timestamp":1621920231000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":59,"title":["CAVA (Ultrasound\u2010Accelerated Catheter\u2010Directed Thrombolysis on Preventing Post\u2010Thrombotic Syndrome) Trial: Long\u2010Term Follow\u2010Up Results"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8270-2000","authenticated-orcid":false,"given":"Pascale","family":"Notten","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery Maastricht University Medical Centre Maastricht the Netherlands"},{"name":"CARIM Cardiovascular Research Institute MaastrichtSchool for Cardiovascular DiseasesMaastricht University Medical Centre Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 A. E. A.","family":"de Smet","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Maasstad hospital the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0771-5231","authenticated-orcid":false,"given":"Lidwine W.","family":"Tick","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Maxima Medical Centre Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marl\u00e8ne H. W.","family":"van de Poel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Laurentius hospital Roermond the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otmar R. M.","family":"Wikkeling","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Nij Smellinghe hospital Drachten the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis\u2010Jean","family":"Vleming","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Haga hospital The Hague the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ad","family":"Koster","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine VieCuri Medical Centre Venlo the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7471-0094","authenticated-orcid":false,"given":"Kon\u2010Siong G.","family":"Jie","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Zuyderland Medical Centre Sittard the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther M. G.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Elkerliek hospital Helmond the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harm P.","family":"Ebben","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Amsterdam University Medical Centres, location VUmc Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Coppens","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine Amsterdam Cardiovascular SciencesAmsterdam University Medical Centres, location AMC Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7796-4463","authenticated-orcid":false,"given":"Hugo","family":"ten Cate","sequence":"additional","affiliation":[{"name":"CARIM Cardiovascular Research Institute MaastrichtSchool for Cardiovascular DiseasesMaastricht University Medical Centre Maastricht the Netherlands"},{"name":"Laboratory for Clinical Thrombosis and Hemostasis Maastricht University Maastricht the Netherlands"},{"name":"Thrombosis Expertise Centre Heart+Vascular CentreMaastricht University Medical Centre Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7796-177X","authenticated-orcid":false,"given":"Cees H. 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