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Image-Guided Treatment for DVT Could Improve Long-Term Outcomes

By MedImaging International staff writers
Posted on 04 Nov 2009

Deep venous thrombosis (DVT) is a severe condition that involves the formation of a blood clot inside of a deep vein usually in the legs. A patient with DVT is typically treated with anticoagulants (blood thinners); however, researchers have found that image-guided interventional radiology procedures may play a more central role in the long-term treatment of DVT.

"DVT is estimated to occur in nearly one million persons per year in the United States alone,” said Suresh Vedantham, M.D., from Mallinckrodt Institute of Radiology at the Washington University School of Medicine in St. Louis, MO, USA), U.S. lead investigator of the trial, and lead author of the study. "The anticoagulant treatment method is good at preventing pulmonary emboli, however it does not completely destroy a blood clot or prevent a patient from developing long-term complications--including chronic, daily leg pain, swelling, changes in skin color, and open sores,” said Dr. Vedantham.

The study was published in the October 2009 issue of the American Journal of Roentgenology (AJR). Dr. Vedantham further stated, "Image-guided pharmacomechanical catheter-directed thrombolysis, which until recently has been typically used to treat only the most critical DVT cases, involves the delivery of a clot-busting drug through a catheter-mounted device that also ‘chews' up a clot, eliminating it completely and possibly improving a patient's long-term outcome and preventing future occurrences. If this technique is proven to prevent long-term DVT complications and improve patient outcomes, it only makes sense to use it on many more patients with DVT.”

Dr. Vedantham noted that most patients with DVT are not aware that there are image-guided treatment options available. That is why it is important for referring physicians and radiologists to communicate more because patients can really benefit from these procedures.

"At this time we do not have any definitive proof that image-guided procedures will improve patient outcome in the long-term. However, the NIH [U.S. National Institutes of Health, Bethesda, MD, USA] is now funding a pivotal, national clinical trial (ATTRACT Trial) to see if routine clot removal is the best way to treat DVT. If the trial is positive, it will revolutionize the treatment of DVT,” concluded Dr. Vedantham, the national principal investigator of the trial.

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63 (288.00964355469): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

64 (45.061111450195): select jos_twitters.link from jos_twitters where cat=10

65 (74.148178100586): select jos_facebook.link from jos_facebook where cat=10

66 (31.948089599609): select jos_google_plus.link from jos_google_plus where cat=10

67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE id=294726250 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294726250 AND published='1' LIMIT 1

69 (30.994415283203): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (254.86946105957): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294726250 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (235.08071899414): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294726250 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (37.908554077148): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (50.067901611328): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294726250 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.040740966797): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294726250 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (31.948089599609): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

105 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

106 (51.021575927734): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726250 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (45.061111450195): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726250 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

109 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

110 (46.014785766602): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294726250 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (488.0428314209): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294726250 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (639.91546630859): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (381.9465637207): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

115 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

116 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

117 (38.14697265625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

118 (42.200088500977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

119 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

120 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

121 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

122 (252.96211242676): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 23082.01789856): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (611.0668182373): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294726250 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294726250 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 8347.9881286621): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (108.00361633301): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (56.982040405273): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (36.954879760742): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (50.067901611328): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (329.97131347656): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (39.100646972656): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (31.948089599609): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (36.001205444336): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (514.03045654297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (404.83474731445): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (253.91578674316): SELECT name FROM jos_deeppockets WHERE id=212

138 (37.908554077148): SELECT name FROM jos_deeppockets WHERE id=212

139 (646.82960510254): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (534.0576171875): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

142 (54.836273193359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

143 (!!!!! 8332.0140838623): TRUNCATE TABLE jos_trademed_module

144 (87.02278137207): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726250 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (51.975250244141): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726250 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (331.87866210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

149 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

150 (!!!!! 1080.0361633301): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

152 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

153 (38.862228393555): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294726250 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294726250 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (33.855438232422): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

155 (31.948089599609): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

156 (33.855438232422): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (84.877014160156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

158 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726250 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726250 AND published='1' LIMIT 1

159 (41.007995605469): select jos_twitters.link from jos_twitters where cat=10

160 (28.848648071289): select jos_facebook.link from jos_facebook where cat=10

161 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

162 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

163 (267.98248291016): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1049.0417480469): insert into jos_banners_delta values (14615,'2025-06-29 01:24:40','216.73.216.249','view'),(14202,'2025-06-29 01:24:40','216.73.216.249','view'),(14203,'2025-06-29 01:24:40','216.73.216.249','view')

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