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Endovascular Management of Pediatric Deep Venous Thrombosis

Vaz Zavaletta1, Beth B Warren2, Danielle Katz1

  • 1Division of Pediatric Radiology, Department of Radiology, University of Colorado, Children's Hospital Colorado, Aurora, Colorado.

Seminars in Interventional Radiology
|October 13, 2025
PubMed

Insights

This review covers thrombolysis and thrombectomy for pediatric deep venous thrombosis (DVT). Endovascular therapies are increasingly used alongside anticoagulation to prevent complications and preserve venous patency in children.

Area of Science:

  • Pediatric Hematology
  • Interventional Radiology
  • Vascular Medicine

Background:

  • Pediatric deep venous thrombosis (DVT) management has evolved from anticoagulation to advanced endovascular therapies.
  • A multidisciplinary approach involving pediatric hematology and interventional radiology is crucial for optimal DVT care in children.

Purpose of the Study:

  • To review current practices in thrombolysis and thrombectomy for pediatric DVT.
  • To outline indications, contraindications, and techniques for endovascular procedures in children.
  • To emphasize the importance of multidisciplinary collaboration in managing pediatric thrombosis.

Main Methods:

  • Review of current literature on pediatric DVT management.
  • Analysis of indications, contraindications, and procedural techniques for thrombolysis and thrombectomy.
  • Emphasis on multidisciplinary team roles and pediatric-specific considerations.

Main Results:

  • Anticoagulation remains standard, but endovascular therapies are vital for extensive or limb-threatening DVT.
  • Procedures reviewed include catheter-directed thrombolysis, pharmaco-mechanical thrombectomy (PMT), mechanical thrombectomy, and venous stenting.
  • Multidisciplinary collaboration is key to addressing pediatric-specific factors like size, sedation, radiation, and contrast dose.

Conclusions:

  • Endovascular therapies play an increasing role in pediatric DVT management, aiming to prevent pulmonary embolism and postthrombotic syndrome (PTS).
  • Successful management requires careful consideration of pediatric-specific factors and robust postprocedural care, including anticoagulation and imaging follow-up.
  • Enhanced outcomes for pediatric thrombotic disease depend on strong collaboration among pediatric hematologists, interventional radiologists, and other specialists.

Keywords:
DVTanticoagulationpediatricthrombectomythrombolysis

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