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Published on: June 4, 2021
Current Evidence for Endovascular Therapies in the Management of Acute Deep Vein Thrombosis
Adam N Plotnik1, Zachary Haber2, Stephen Kee3
1Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 2125, Los Angeles, CA, 90095, USA. aplotnik@mednet.ucla.edu.
Insights
Acute deep vein thrombosis (DVT) can lead to chronic post-thrombotic syndrome (PTS). Percutaneous interventions offer advanced treatment options for DVT management beyond anticoagulation alone.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiology
Background:
- Acute lower extremity deep vein thrombosis (DVT), particularly proximal iliofemoral DVT, is a common condition.
- It can lead to chronic, debilitating post-thrombotic syndrome (PTS), significantly impacting patient quality of life.
Purpose of the Study:
- To review current endovascular techniques for DVT management.
- To discuss the existing data on percutaneous interventions as treatment options for DVT.
Main Methods:
- Review of existing data on percutaneous interventions for DVT.
- Discussion of current endovascular techniques: catheter-directed thrombolysis, pharmacomechanical thrombectomy, and large-bore mechanical thrombectomy.
Main Results:
- Anticoagulation is the primary treatment for DVT.
- Percutaneous interventions are emerging options for select DVT patients to improve outcomes and prevent PTS.
Conclusions:
- Endovascular techniques offer promising alternatives for managing DVT, especially in cases where anticoagulation alone may be insufficient.
- These interventions aim to resolve DVT effectively and mitigate the risk of developing PTS.
Abstract:
Acute lower extremity deep vein thrombosis (DVT), specifically proximal iliofemoral DVT, is a relatively common disorder that can result in a chronic debilitating post-thrombotic syndrome (PTS), with a significant effect on a patient's quality of life. Anticoagulation is first-line therapy; however, percutaneous interventions have emerged as treatment options for patients where there is concern that anticoagulation alone will not resolve the DVT as well as prevent PTS. This paper will discuss the existing data on these interventions and review current endovascular techniques, including catheter-directed thrombolysis, pharmacomechanical thrombectomy, and large-bore mechanical thrombectomy in the management of DVT.
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