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Interventional approaches to deep venous thrombosis

Kristen A Lee1, Raja S Ramaswamy

  • 1aDepartment of Radiology and Biomedical Imaging, University of California, San Francisco, California bSection of Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University of St. Louis, Saint Louis, Missouri, USA.

Current Opinion in Cardiology
|July 19, 2017
PubMed

Insights

Catheter-directed therapy (CDT) effectively removes deep vein thrombosis (DVT) and reduces postthrombotic syndrome. This endovascular approach offers a safe and beneficial treatment option for selected DVT patients.

Area of Science:

  • Vascular Medicine
  • Interventional Cardiology
  • Thrombosis Management

Background:

  • Anticoagulation alone is insufficient for some deep vein thrombosis (DVT) cases.
  • Catheter-directed therapy (CDT) serves as an adjunct treatment for DVT.
  • Endovascular management of DVT requires updated discussion on its efficacy and safety.

Purpose of the Study:

  • To review the rationale for CDT in DVT.
  • To discuss the safety profile of endovascular DVT management.
  • To analyze clinical outcomes of CDT for DVT.

Main Methods:

  • Review of early studies on catheter-directed thrombolysis (CDT).
  • Analysis of the Catheter-Directed Venous Thrombolysis in Acute Iliofemoral Vein Thrombosis trial.
  • Inclusion of recent randomized trials and ongoing studies like the Acute Venous Thrombosis trial.

Main Results:

  • CDT demonstrates success in rapid thrombus removal.
  • CDT is associated with a lower incidence of postthrombotic syndrome (PTS).
  • Long-term benefits of CDT are supported by 5-year follow-up data; pharmacomechanical CDT shows promise but requires further long-term efficacy studies.

Conclusions:

  • Catheter-directed therapy is a well-tolerated treatment for selected acute proximal DVT patients.
  • CDT offers significant reduction in PTS incidence.
  • Ongoing trials will further define the role of pharmacomechanical CDT in DVT management.
Abstract

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