The background and role of catheter-directed thrombolysis evolving procedures for acute iliofemoral deep venous thrombosis

Niels Biekgaard*, Marie Josee E. van Rijn

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

2 Citations (Scopus)

Abstract

Minimal invasive treatment such as early endovenous thrombus removal for iliofemoral deep venous thrombosis (DVT) emerged in the end of last century. The principle is catheter-directed thrombolysis (CDT) using either plasminogen activating agents alone, as ultrasound-assisted CDT, or in combination with mechanical devices as pharmaco-mechanical CDT . The interest for this treatment modality is the high rate of postthrombotic syndrome (PTS) with anticoagulation (AC) alone, especially after iliofemoral DVT. Recently published randomized controlled trials (RCTs) comparing early thrombus removal with AC alone, as well as non-randomized studies, have demonstrated favorable rates, or at least a decrease of moderate and severe PTS, in favor of these procedures. This article will summarize the background and evolution of the procedures in the last three decades and discuss fundamental criteria for inclusion and exclusion, focusing on the procedures regarding thrombus age and location, technical issues, complications and results including different outcome measures for PTS, for which iliac DVT involvement is a massive risk factor to be prevented.

Original languageEnglish
Pages (from-to)12-22
Number of pages11
JournalJournal of Cardiovascular Surgery
Volume65
Issue number1
Early online date23 Jan 2024
DOIs
Publication statusPublished - Feb 2024

Bibliographical note

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© 2024 Edizioni Minerva Medica. All rights reserved.

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