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Endovascular Therapy for Venous Thromboembolic Diseases
Yi-Jia Su1, Hsien-Yuan Chang1,2, Yi-Heng Li1
1Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University.
Acta Cardiologica Sinica
|November 23, 2021
Summary
Catheter-directed thrombolysis offers a safer, lower-dose alternative for venous thromboembolic events. Pharmacomechanical and percutaneous mechanical methods further enhance safety and efficacy, showing promise for endovascular therapy.
Area of Science:
- Vascular Medicine
- Interventional Cardiology
- Medical Devices
Background:
- Venous thromboembolic events (VTE) pose significant risks, especially with unstable hemodynamics.
- Current treatments include systemic thrombolysis, which carries a high bleeding risk.
- Catheter-directed thrombolysis (CDT) is an established alternative for specific patient groups.
Purpose of the Study:
- To review the role and advancements in endovascular therapies for VTE.
- To compare the safety and efficacy profiles of different thrombolytic strategies.
- To highlight the potential of emerging mechanical devices.
Main Methods:
- Review of standard catheter-directed thrombolysis.
- Analysis of pharmacomechanical catheter-directed thrombolysis (PM-CDT).
- Evaluation of percutaneous mechanical thrombolysis (PMT) and other endovascular devices.
Main Results:
- CDT uses lower thrombolytic doses than systemic thrombolysis, reducing bleeding risk.
- PM-CDT further lowers thrombolytic agent dosage and infusion time.
- PMT presents a viable option for patients unsuitable for thrombolytic agents.
Conclusions:
- Endovascular therapy, including CDT, PM-CDT, and PMT, offers improved safety and efficacy for VTE.
- Advancements in devices and ongoing trials suggest a promising future for endovascular treatment of VTE.
- These minimally invasive techniques are crucial for managing complex venous thromboembolic diseases.
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