Evidence for clot-dissolving treatment in children remains very uncertain
In children with vein clots, adding clot-dissolving treatment to anticoagulation had uncertain benefits and possible bleeding risks. Results differed by clot location and severity, with very low evidence certainty.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
For children with these clots, the review could not establish a reliable overall benefit from adding clot-dissolving treatment. Some subgroups showed possible benefits, while others showed possible harm, including bleeding. All conclusions rested on very-low-certainty evidence, so the findings cannot determine which treatment is preferable for an individual child or clot type.
All included studies were nonrandomized. Other differences between treatment groups and small samples made the estimates difficult to interpret. The abstract reports particularly limited evidence for clots in brain drainage veins and kidney veins.
Clot location changed the picture
For lung clots with impaired circulation, clot-dissolving treatment was associated with possibly lower mortality. For clots in the heart’s right upper chamber, the review suggested possible increases in major bleeding and mortality, with little difference in clot clearance.
Other outcomes also remained uncertain
For limb vein clots, mortality and clot clearance may have differed little. Postthrombotic syndrome, meaning ongoing problems after a vein clot, may have been less common. These possible benefits did not resolve the review’s broader uncertainty about bleeding.
The original publication
Efficacy and safety of thrombolysis for pediatric venous thromboembolism: a systematic review and meta-analysis.
Kawtharany H, Azzam M, Alkhader A et al.
Blood Adv · 2025
- PubMed ID
- 40561511
- Record checked
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