Aug 2, 2011

Inflammatory bowel disease-associated thromboembolism: a systematic review of outcomes with anticoagulation versus catheter-directed thrombolysis

Inflammatory Bowel Diseases
James H Tabibian, Michael B Streiff

Abstract

Thromboembolism (TE) is a common extraintestinal complication of inflammatory bowel disease (IBD). Catheter-directed thrombolysis (CDT) is being increasingly used to treat TE but often evokes fears of hemorrhagic complications (HCs) in patients with IBD. We reviewed clinical outcomes with anticoagulation (AC) and CDT in IBD patients with TE. Published cases of IBD patients with TE were identified by a PubMed search. Cases were divided into two groups based on treatment modality: AC alone or CDT. Pretreatment variables and treatment-related outcomes were compared between treatment groups. Fifty-two cases of IBD-associated TE were identified. Thirty-five cases were treated with AC alone and 17 with CDT. There were no significant differences in pretreatment variables. Patients treated with CDT tended to be more likely to achieve complete or partial symptomatic (P = 0.02) and radiologic resolution (P = 0.06). Gastrointestinal (GI) and non-GI HCs tended to occur more frequently with CDT, although these differences were not statistically significant (P = 0.44 and 0.15, respectively). CDT and AC both appear to be well tolerated by IBD patients with TE. CDT may be used preferentially in patients with life-threatening TE, while AC may b...Continue Reading

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Mentioned in this Paper

Diagnostic Radiology Modality
Negative Regulation of Coagulation
Decreased Coagulation Activity [PE]
Thromboembolism
Complication
Catheter Related Infection
Inflammatory Bowel Diseases
Indirect Thrombin Inhibitors
Catheter Ablation, Transvenous
Thrombolytic Therapy

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