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Pediatric Venous Thromboembolism: Considerations for the Interventional Radiologist
William Mitchell1, Michael H White1, Prashant Raghavendran1
1Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia.
Seminars in Interventional Radiology
|October 13, 2025
Summary
Pediatric venous thromboembolism (VTE) is rising, requiring individualized treatment. While anticoagulation is standard, interventional therapies are increasingly used for severe cases in children, demanding careful, collaborative approaches.
Area of Science:
- Pediatric Hematology
- Interventional Cardiology
- Vascular Medicine
Background:
- Pediatric venous thromboembolism (VTE) prevalence is increasing, linked to advanced medical treatments in children.
- Current VTE management relies on anticoagulation but lacks pediatric-specific evidence for interventions.
- Individualized treatment is crucial due to age-related hemostasis differences and intervention risks.
Purpose of the Study:
- To explore the pathophysiology, risk factors, and management of pediatric VTE.
- To review pharmacologic and interventional treatment options for pediatric VTE.
- To provide updated recommendations for anticoagulant agents and VTE management paradigms in children.
Main Methods:
- Literature review of pediatric VTE studies.
- Analysis of pathophysiology and risk factors.
- Evaluation of pharmacologic and interventional treatment strategies.
Main Results:
- Increasing evidence supports interventional approaches for select pediatric VTE cases, especially life- or limb-threatening scenarios.
- Specific conditions like Paget-Schroetter syndrome, SVC syndrome, IVC atresia, PE, and May-Thurner syndrome may benefit from interventions.
- Treatment must account for age-related hemostasis and higher bleeding risks.
Conclusions:
- Individualized treatment strategies are essential for pediatric VTE.
- Interventional techniques show potential in specific pediatric VTE conditions.
- Multidisciplinary collaboration and standardized approaches are vital for optimal outcomes in pediatric VTE management due to limited clinical trial data.
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