Magnuson EA, Chinnakondepalli K, Vilain K, et al. - From the perspective of the US healthcare system, researchers compared 2 treatment strategies to prevent postthrombotic syndrome in patients with acute deep vein thrombosis (DVT): pharmacomechanical catheter-directed thrombolysis (PCDT) vs anticoagulation therapy, with respect to long-term costs and cost-effectiveness. A total of 692 patients with acute proximal DVT, who were enrolled in the ATTRACT trial (Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter-Directed Thrombolysis), were randomized to PCDT plus anticoagulation (n = 337) or standard treatment with anticoagulation alone (n = 355). These patients were observed for 24 months in order to determine costs (2017 US dollars), using a combination of resource-based costing, hospital bills, Medicare reimbursement rates, and the Drug Topics Red Book. According to the findings, PCDT does not afford an economically attractive treatment for proximal DVT, with an incremental cost-effectiveness ratio > $200 000/quality-adjusted life year gained. The possible intermediate value of PCDT was suggested in patients with iliofemoral DVT.