Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-directed Thrombolysis (ATTRACT) Trial
SIR 2017–2018 President Suresh Vedantham, MD, FSIR, from the Washington University School of Medicine, developed the Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-directed Thrombolysis (ATTRACT) Trial through an SIR Foundation Research Consensus Panel (RCP) in 2004. ATTRACT was designed to evaluate the ability of pharmacomechanical catheter-directed thrombolysis (PCDT) to reduce the incidence and severity in patients with acute proximal deep vein thrombosis (DVT). ATTRACT was submitted to the National Heart, Lung and Blood Institute (NHLBI) in 2008 and received $10.2 million in funding. SIR Foundation participated as a collaborating institution in the development and execution of the trial. ATTRACT is the first national multicenter, randomized trial to compare the ability of two treatment strategies, standard treatment (consisting of anticoagulants and the use of elastic compression stockings), and PCDT in addition to the standard treatment. The study has completed accrual of its originally planned cohort of 692 patients in 56 hospitals.
At the SIR 2017 Annual Scientific Meeting, Dr. Vedantham presented data that demonstrates that most patients with DVT do not experience long-term benefits from PCDT. However, ATTRACT found that they do experience greater relief of initial leg pain and swelling, and some patients experience a significant reduction in the risk of developing moderate-to-severe post-thrombotic syndrome (PTS). The results are important in identifying which patients may benefit most from the combination treatment of PCDT with blood-thinning drugs. This will help interventional radiologists and other health care professionals deliver more cost-effective care by eliminating unnecessary treatments to other patients.