Advances in endovascular interventions for deep vein thrombosis

Deep vein thrombosis (DVT) can lead to significant clinical sequelae resulting in negative impact on patients' lifestyle. Clinical consequences of DVT may include acute symptoms, such as limb swelling and pain or chronic symptoms, such as venous ulceration, due to post-thrombotic syndrome. An overwhelming DVT may lead to sudden death due to pulmonary embolism. Conventional treatment of DVT includes initial systemic anticoagulation with possible thrombus removal in symptomatic patients who fail medical therapy. Recent advances in endovascular technologies have led to the development of a variety of minimally invasive, catheter-based strategies to remove venous thrombus. These technologies utilize various mechanical principles, including catheter-directed thrombolytic infusion, rheolytic thrombectomy, mechanical fragmentation or ultrasound energy to remove intraluminal thrombus. The adjunctive role of thrombolytic agents in these mechanical thrombectomy devices has resulted in an augmented treatment modality in interventional management of iliofemoral DVT. This article reviews the current advances in this technology and discusses the techniques of percutaneous treatment strategies of venous thrombotic conditions.