[Recanalization techniques for venous outflow obstruction]

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Cardiology

Background:

• Deep vein thrombosis (DVT) poses significant healthcare costs due to complications like pulmonary embolism and post-thrombotic syndrome (PTS).
• Standard anticoagulation therapy for DVT has limitations, particularly for iliofemoral vein thrombus, leaving patients at high risk for PTS.
• Chronic iliac vein obstruction necessitates advanced treatment options beyond anticoagulation.

Purpose of the Study:

• To evaluate the efficacy of endovascular treatments for iliofemoral DVT.
• To assess the role of active thrombus removal in preventing post-thrombotic syndrome (PTS).
• To highlight the availability of venous stents and recanalization for chronic iliac vein obstructions.

Main Methods:

• Review of current endovascular treatment strategies for iliofemoral DVT.
• Analysis of catheter-directed therapy (CDT) and pharmacomechanical thrombectomy (PMT) for thrombus removal.
• Consideration of venous stenting and recanalization techniques for chronic venous obstruction.

Main Results:

• Endovascular approaches, including CDT and PMT, facilitate active thrombus removal in iliofemoral DVT.
• These methods improve valvular vein function and luminal patency.
• Available venous stents and recanalization techniques address chronic iliac vein obstructions.

Conclusions:

• Active thrombus removal via endovascular therapy is a viable strategy for treating iliofemoral DVT.
• These interventions can significantly reduce the risk of developing post-thrombotic syndrome (PTS).
• Modern endovascular techniques offer improved outcomes for patients with DVT and chronic venous obstructions.