Mechanical thrombectomy in deep venous thrombosis

Multiple sequelae may occur after deep venous thrombosis (DVT) including acute limb symptoms, such as swelling and pain, valvular damage and reflux leading to chronic symptoms, and, the most serious, pulmonary embolism and death. Conventional therapy consists of anticoagulation with heparin and warfarin in the setting of an acute DVT, which prophylaxes against clot propagation and pulmonary embolism but does not relieve thrombus burden. The delayed complications of DVT, known as the post-phlebitic syndrome, are due to valvular damage from chronic thrombus and scarring. Endovascular management utilizing percutaneous mechanical thrombectomy alone or in combination with pharmacological thrombolytic agents is safe and effective in relief of thrombus burden. Along with possible preservation of venous valve function, inciting anatomic lesions may be treated simultaneously. This article explores the use of percutaneous mechanical thrombectomy in the treatment of venous thrombotic disease.