Interventions in Acute Venous Thrombosis: Proceedings from the Society of Interventional Radiology Foundation...

Acute deep vein thrombosis (DVT) is associated with substantial long-term morbidity, primarily through the development of postthrombotic syndrome (PTS). While endovascular strategies aim to clear thrombus and preserve venous patency, randomized evidence has not demonstrated consistent reductions in overall PTS across a broad DVT patient population. New clinical and basic research into individual variability in vein wall inflammation and fibrosis, ability to mount endogenous fibrinolysis, response to antithrombotic therapy, and impact of timing of treatment initiation continue to refine our understanding of overall susceptibility to PTS. Thrombectomy devices remain focused on short-term venous patency, while freedom from PTS is achieved with long-term venous patency, minimization of recurrent thrombotic episodes, and a reduction of perivenous inflammation. Endovascular DVT trial end points remain heterogeneous and frequently emphasize anatomic thrombus reduction without standardized physiologic, biologic, or patient-centered correlates. Recognizing these gaps in evidence, methodology, and end point standardization, the Society of Interventional Radiology (SIR) Foundation convened a multidisciplinary Research Consensus Panel to define research priorities and establish standardized frameworks for outcome determination in acute DVT intervention. Expert panelists representing interventional radiology, vascular surgery, vascular medicine, and hematology delivered structured presentations, followed by moderated discussion and weighted ranking of proposed research initiatives. The resulting agenda emphasizes biologically informed patient selection, standardized anatomic and physiologic metrics, validated acute DVT severity instruments, longitudinal biomarker integration, and incorporation of economic and quality-of-life measures to advance precision and clinically meaningful DVT investigation.