Abstract
The basic treatment of deep vein thrombosis (DVT) over the past several decades has consisted of anticoagulation only, with inferior vena cava filtration for those who either failed or could not tolerate anticoagulation. Until recently no randomized trials had studied the efficacy of thrombolysis in DVT despite advances in techniques and technologies for endovascular clot removal. This article is a review of the current evidence on catheter-based therapies for patients with DVT. Technical considerations to improve outcome as well as optimal patient selection are discussed.
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Prandoni P, Lensing AWA, Cogo A, Cuppini S, Villalta S, Carta M, et al. The long-term clinical course of acute deep venous thrombosis. Ann Intern Med. 1996;125(1):1–7.
Kahn SR, Ducruet T, Arsenault L, Miron MJ, Roussin A, Desmarais S, et al. Incidence, timing of onset and severity of post-thrombotic syndrome after acute symptomatic deep vein thrombosis: two-year results from a Canadian multicenter prospective cohort study (the VETO Study). Blood. 2005;106:1636. abstract.
Goldhaber SZ, Tapson VF. A prospective registry of 5,451 patients with ultrasound-confirmed deep vein thrombosis. Am J Cardiol. 2004;93:259–62.
Semba CP, Dake MD. Iliofemoral deep venous thrombosis: aggressive therapy with catheter-directed thrombolysis. Radiology. 1994;191(2):487–94.
Razavi MK, Semba CP. The changing role of thrombolytic therapy in the management of acute deep vein thrombosis. Therapy. 2005;2(1):57–9.
Ginsberg JS, Hirsh J, Julian J, et al. Prevention and treatment of postphlebitic syndrome: results of a 3-part study. Arch Intern Med. 2001;16:2105–9.
El Sayed HF, Kougias P, Zhou W, Lin PH. Utility of retrievable vena cava filters and mechanical thrombectomy in the endovascular management of acute deep venous thrombosis. Vascular. 2006;14(5):305–12.
Kim HS, Patra A, Paxton BE, Khan J, Streiff MB. Catheter-directed thrombolysis with percutaneous rheolytic thrombectomy versus thrombolysis alone in upper and lower extremity deep vein thrombosis. Cardiovasc Intervent Radiol. 2006;29(6):1003–7.
Lin PH, Zhou W, Dardik A, Mussa F, Kougias P, Hedayati N, et al. Catheter-direct thrombolysis versus pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis. Am J Surg. 2006;192(6):782–8.
Parikh S, Motarjeme A, McNamara T, Raabe R, Hagspiel K, Benenati JF, et al. Ultrasound-accelerated thrombolysis for the treatment of deep vein thrombosis: initial clinical experience. J Vasc Interv Radiol. 2008;19(4):521–8.
O’Sullivan GO, Semba CP, Bittner CA, Kee ST, Razavi MK, Sze DY, et al. Endovascular management of iliac vein compression (May-Thurner) syndrome. JVIR. 2000;11:823–36.
Razavi M, Hansch E, Kee S, Sze D, Semba C, Dake M. Endovascular treatment of chronically occluded inferior venae cavae. Radiology. 2000;214:133–8.
Mewissen WM, Seabrook GR, Meissner MH, Cynamon J, Labropoulos N, Haughton SH. Catheter-directed thrombolysis for lower extremity deep venous thrombosis: report of a national multicenter registry. Radiology. 1999;211:39–49.
Semba CP, Razavi MK, Kee ST, Sze DY, Dake MD. Thrombolysis for lower extremity deep venous thrombosis. Tech Vasc Interv Radiol. 2004;7(2):68–78.
Enden T, Haig Y, Klow N, et al. Long-term outcomes after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet. 2012;379(9810):31–8. This is the first multicenter prospective randomized trial demonstrating the superiority of CDT over anticoagulation alone.
Haig Y, Enden T, Slagsvold C, et al. Determinants of early and long-term efficacy of catheter-directed thrombolysis in proximal deep vein thrombosis. J Vasc Interv Radiol. 2013;24(1):17–24.
Razavi M, Brook S, Dan H, Jodi A. Clinical and economic evaluation of the Trellis Infusion system for DVT: a preliminary analysis. JVIR. 2005;16:S107.
Vedantham S, Kalva S, Klein S, Nayak L, Razavi MK, Sista, A. Society of Intervenional Radiology Standards of Practice Committee. Revised quality improvement guidelines for the treatment of lower extremity DVT with the use of Endovascular Thrombus Removal. J Vasc Interv Radiol. 2014. This is a thorough review of the relevant literature in catheter-based interventions for DVT, including recommendations for acceptable outcomes.
Patel N, Sacks D, Patel RI, et al. SIR reporting standards for the treatment of acute limb ischemia with use of transluminal removal of arterial thrombus. J Vasc Interv Radiol. 2003;14:S453–65.
Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease. Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2):e419S–94. This is a comprehensive review of anticoagulation in DVT with evidence-based recommendations.
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Mahmood K. Razavi has been an advisor to Abbott Vascular, Boston Scientific, Bard, Covidien, Trivascular, Veneti, and Neuravi.
Emmad Karmouta declares that he has no conflict of interest.
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This article does not contain any studies with human or animal subjects performed by any of the authors.
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This article is part of the Topical Collection on Peripheral Vascular Disease
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Razavi, M.K., Karmouta, E. Catheter-Based Therapies for Deep Vein Thrombosis. Curr Cardiol Rep 16, 497 (2014). https://doi.org/10.1007/s11886-014-0497-0
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DOI: https://doi.org/10.1007/s11886-014-0497-0