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Catheter-Directed Thrombolysis for Postpartum Deep Venous Thrombosis
Miguel Girona1, Christoph Säly2, Vladimir Makaloski3
1Division of Angiology, Swiss Cardiovascular Center, University Hospital of Bern (Inselspital), University of Bern, Bern, Switzerland.
Frontiers in Cardiovascular Medicine
|May 13, 2022
Summary
Catheter-directed thrombolysis (CDT) offers a treatment alternative for postpartum deep vein thrombosis. This review examines CDT safety in the peri- and postpartum periods, highlighting its use in iliofemoral thrombosis management.
Area of Science:
- Obstetrics and Gynecology
- Vascular Surgery
- Hematology
Background:
- Venous thromboembolism (VTE) poses significant risks during pregnancy and postpartum.
- Endovascular recanalization with thrombolysis is an alternative to anticoagulation for acute proximal deep vein thrombosis.
- Limited data exists on the bleeding risks associated with thrombolysis in the postpartum period.
Purpose of the Study:
- To evaluate the safety outcomes of catheter-directed thrombolysis (CDT) in the peri- and postpartum periods.
- To address the clinical question regarding the bleeding risk of thrombolysis in postpartum VTE.
- To review the management of postpartum acute iliofemoral thrombosis treated with CDT.
Main Methods:
- A non-exhaustive literature review was conducted.
- Case illustration of postpartum acute iliofemoral thrombosis management.
- Review of endovascular revascularization techniques including thrombectomy, balloon angioplasty, and stenting.
Main Results:
- Catheter-directed thrombolysis (CDT) is a viable therapeutic option for postpartum deep vein thrombosis.
- The study illustrates successful management of a complex postpartum iliofemoral thrombosis case.
- Data on bleeding risks associated with postpartum CDT requires further investigation.
Conclusions:
- Catheter-directed thrombolysis (CDT) can be safely considered for postpartum venous thromboembolism.
- Endovascular revascularization techniques are crucial in managing severe postpartum iliofemoral thrombosis.
- Further research is needed to comprehensively assess the safety profile of CDT in the postpartum population.
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