Citations 2
Efficacy and safety of thrombolysis for pediatric venous thromboembolism: a systematic review and meta-analysis
Kawtharany, Hassan , Azzam, Muayad , Alkhader, Aseel, Betensky, Marisol , Hamarsha, Qais, Mansour, Razan , Tabak, Carine , Bhat, Rukhmi , Biss, Tina , Brandão, Leonardo R. , Chan, Anthony K.C. , Faustino, E. Vincent S. , Jaffray, Julie , Jones, Sophie , Kerlin, Bryce A. , Pelland‐Marcotte, Marie‐Claude , Raulji, Chittalsinh M , Sartain, Sarah E. , Ommen, C. Heleen van , Wiernikowski, John , Williams, Suzan , Wilson, Hope P. , Woods, Gary , Zia, Ayesha , Abou Zeid, Hadi K, Brandão, Leonardo R , Chan, Anthony K C , Jaffray, Julie , Jones, Sophie , Kerlin, Bryce A , Kucine, Nicole , Male, Christoph , Pelland-Marcotte, Marie-Claude , Raffini, Leslie , Raulji, Chittalsinh M , Tarango, Cristina , van Ommen, C Heleen , Velez, Maria C , Vesely, Sara K , Zia, Ayesha , Monagle, Paul , Mustafa, Reem A , Kawtharany, Hassan , Hamarsha, Qais , Zeid, Hadi Khaled Abou , Patel, Payal Mukesh , Baghdadi, Sarah L., Bercovitz, Rachel S. , Branchford, Brian R. , Kumar, Riten , Takemoto, Clifford M.
Blood Advances | June 25, 2025 | Volume: 9 | Issue: 21 | Pages: 5512-5527
10.1182/bloodadvances.2025017058
Abstract We conducted this systematic review to evaluate outcomes of thrombolysis followed by anticoagulation vs anticoagulation alone in pediatric patients with venous thromboembolism (VTE). This systematic review addresses mortality, VTE resolution, recurrence, bleeding, and organ-specific outcomes in 5 PICO (population, intervention, comparison, outcomes) questions on thrombolysis across pulmonary embolism (PE), extremity deep vein thrombosis (DVT), right atrial thrombosis (RAT), cerebral sinus venous thrombosis (CSVT), and renal vein thrombosis (RVT). Meta-analysis reported risk ratios or differences (95% confidence intervals [CIs]), and absolute effects per 1000 patients. Certainty of evidence was assessed using GRADE (Grading of recommendation, assessment, Development, and Evaluation) guidelines. Thirteen nonrandomized studies were included and no randomized clinical trials addressed these questions. Thrombolysis might be associated with a higher risk of major bleeding, clinically relevant nonmajor bleeding, or unspecified bleeding with risk differences of 0.09 (95% CI, −0.06 to 0.23), 0.06 (95% CI, −0.11 to 0.22), and 0.09 (95% CI, −0.04 to 0.23), respectively. In PE with hemodynamic compromise, thrombolysis might be associated with a lower risk of mortality but conclusions on PE progression were uncertain in submassive PE. In DVT, thrombolysis may have little to no effect on mortality or thrombus resolution but might be associated with lower risk of postthrombotic syndrome. In RAT, thrombolysis might have little to no effect on thrombus resolution but a higher risk of major bleeding and mortality. For CSVT and RVT, the evidence was very limited. These findings were based on very-low-certainty evidence because of confounding and imprecision from small sample sizes. This systematic review highlights key challenges in developing recommendations for thrombolysis in children with VTE.
Delayed renal transplant failure secondary to renal vein thrombosis in a patient with a permanent IVC filter
Lewis, K.L. , Wadei, Hani M. , Guru, Pramod , LEWIS, KRISTYN L, Guru, Pramod K , Wadei, Hani M , Patel, Payal Mukesh
BMJ Case Reports | March 29, 2021 | Volume: 14 | Issue: 3 | Pages: e236619
Renal vein thrombosis is a rare, but potentially serious complication in patients with renal transplantation as it can lead to non-reversible graft injury and failure. Often this clinical entity is found in the early transplantation period, and the available management strategies are associated with favourable patient outcomes. The incidence, pathophysiology and outcomes for the delayed occurrence of renal vein thrombosis are unknown. The case here describes a unique situation with an excellent clinical outcome related to early diagnosis and appropriate care.