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Blood, 1 July 2007, Vol. 110, No. 1, pp. 45-53. Prepublished online as a Blood First Edition Paper on March 14, 2007; DOI 10.1182/blood-2006-12-061234. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2006-12-061234v1 110/1/45    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Goldenberg, N. A. Articles by Manco-Johnson, M. J. Search for Related Content PubMed PubMed Citation Articles by Goldenberg, N. A. Articles by Manco-Johnson, M. J. Related Collections Hemostasis, Thrombosis, and Vascular Biology Free Research Articles Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS A thrombolytic regimen for high-risk deep venous thrombosis may substantially reduce the risk of postthrombotic syndrome in children Neil A. Goldenberg1,3, Janette D. Durham4, R. Knapp-Clevenger5, and Marilyn J. Manco-Johnson1,2 1 University of Colorado at Denver and Health Sciences Center, Department of Pediatrics, Section of Hematology/Oncology/Bone Marrow Transplantation and the Center for Cancer and Blood Disorders, The Children's Hospital, Denver; 2 Mountain States Regional Hemophilia and Thrombosis Center, Aurora, CO; 3 University of Colorado at Denver and Health Sciences Center, Department of Internal Medicine, Division of Hematology/Oncology, Denver; 4 University of Colorado at Denver and Health Sciences Center, Department of Radiology, Division of Interventional Radiology, Denver; 5 University of Colorado at Denver and Health Sciences Center, Department of Pediatrics and the Pediatric Clinical Translational Research Center, The Children's Hospital, Denver, CO Important predictors of adverse outcomes of thrombosis in children, including postthrombotic syndrome (PTS), have recently been identified. Given this knowledge and the encouraging preliminary pediatric experience with systemic thrombolysis, we sought to retrospectively analyze our institutional experience with a thrombolytic regimen versus standard anticoagulation for acute, occlusive deep venous thrombosis (DVT) of the proximal lower extremities in children in whom plasma factor VIII activity and/or D-dimer concentration were elevated at diagnosis, from within a longitudinal pediatric cohort. Nine children who underwent the thrombolytic regimen and 13 who received standard anticoagulation alone were followed from time of diagnosis with serial clinical evaluation and standardized PTS outcome assessments conducted in uniform fashion. The thrombolytic regimen was associated with a markedly decreased odds of PTS at 18 to 24 months compared with standard anticoagulation alone, which persisted after adjustment for significant covariates of age and lag time to therapy (odds ratio [OR] = 0.018, 95% confidence interval [CI] = < 0.001-0.483; P = .02). Major bleeding developed in 1 child, clinically judged as not directly related to thrombolysis for DVT. These findings suggest that the use of a thrombolysis regimen may safely and substantially reduce the risk of PTS in children with occlusive lower-extremity acute DVT, providing the basis for a future clinical trial. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Clot busting in kids: less PTS? Leslie Raffini Blood 2007 110: 4-5. [Full Text] [PDF] This article has been cited by other articles: N. A Goldenberg, L. Jacobson, H. Hathaway, M. Tripputi, J. Primeaux, and J. Child Anti-Xa Stability of Diluted Dalteparin for Pediatric Use Ann. Pharmacother., April 1, 2008; 42(4): 511 - 515. [Abstract] [Full Text] [PDF] T. B. Kinane, E. F. Grabowski, A. Sharma, K. Nimkin, M. E. King, and L. D. Cornell Case 7-2008 -- A 17-Year-Old Girl with Chest Pain and Hemoptysis N. Engl. J. Med., February 28, 2008; 358(9): 941 - 952. [Full Text] [PDF]

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