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Updated: Jun 23, 2026
07:50
An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug
Published on: June 4, 2021
Indications for thrombolysis in deep venous thrombosis
P Gogalniceanu1, C J C Johnston, U Khalid
1St George's Regional Vascular Institute, 4th Floor, St James' Wing, St George's Hospital NHS Trust, Tooting, London SW17 0QT, United Kingdom.
Summary
Catheter directed thrombolysis (CDT) shows promise in reducing deep venous thrombosis (DVT) burden and recurrence. Further research is needed to establish long-term benefits and cost-effectiveness for selected patients.
Area of Science:
- Vascular Medicine
- Interventional Cardiology
- Thrombosis Management
Background:
- Deep venous thromboses (DVTs) are a major cause of illness and death.
- Current anticoagulation prevents clot growth but not clot dissolution or post-thrombotic syndrome.
- Catheter directed thrombolysis (CDT) offers an alternative treatment for DVTs, but its indications are not standardized.
Purpose of the Study:
- To review the current literature on deep venous thrombosis (DVT) and thrombolysis.
- To evaluate the effectiveness and indications of catheter directed thrombolysis (CDT) for DVT treatment.
- To identify gaps in the evidence regarding CDT compared to anticoagulation alone.
Main Methods:
- Systematic literature search of PubMed and Cochrane Library for articles on DVT and thrombolysis.
- Inclusion of studies on DVT thrombolysis, anticoagulation, mechanical thrombectomy, venous stenting, and May-Thurner's syndrome.
- Review of data to assess outcomes, indications, and comparative effectiveness of different DVT treatments.
Main Results:
- Catheter directed thrombolysis (CDT) demonstrated reductions in clot burden, DVT recurrence, and potential prevention of post-thrombotic syndrome.
- Recommended indications for CDT include younger patients with good life expectancy, limb-threatening DVTs, and ilio-femoral DVTs.
- A significant lack of randomized controlled trials exists comparing CDT outcomes to anticoagulation alone; further investigation into combined pharmaco-mechanic thrombectomy and caval filters is warranted.
Conclusions:
- Catheter directed thrombolysis (CDT) shows encouraging outcomes in carefully selected DVT patients.
- More evidence is required to confirm long-term benefits and cost-effectiveness of CDT.
- Further research should focus on comparative trials and novel treatment combinations.
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