Interventional approaches to deep venous thrombosis
被引:6
作者:
Lee, Kristen A.
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机构:
Univ Calif San Francisco, Dept Radiol & Biomed Imaging, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Radiol & Biomed Imaging, San Francisco, CA 94143 USA
Lee, Kristen A.
[1
]
Ramaswamy, Raja S.
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Washington Univ, Mallinckrodt Inst Radiol, Sect Intervent Radiol, 510 S Kingshighway Blvd,CB 8131, St Louis, MO 63139 USAUniv Calif San Francisco, Dept Radiol & Biomed Imaging, San Francisco, CA 94143 USA
Ramaswamy, Raja S.
[2
]
机构:
[1] Univ Calif San Francisco, Dept Radiol & Biomed Imaging, San Francisco, CA 94143 USA
[2] Washington Univ, Mallinckrodt Inst Radiol, Sect Intervent Radiol, 510 S Kingshighway Blvd,CB 8131, St Louis, MO 63139 USA
Purpose of review Catheter-directed therapy in deep vein thrombosis (DVT) is a beneficial adjunct treatment when anticoagulation alone does not provide an adequate therapeutic response. This review aims to deliver an up-to-date discussion behind the rationale, safety profile, and clinical outcomes in endovascular management of DVT. Recent findings Early studies have shown that the use of catheter-directed thrombolysis (CDT) to be successful in rapid thrombus removal, carry a lower incidence of postthrombotic syndrome (PTS), and improved quality of life. To date, the most robust study evaluating the use of CDT is the Catheter-Directed Venous Thrombolysis in Acute Iliofemoral Vein Thrombosis trial published in 2012, which demonstrated a relative risk reduction in PTS of 26% in the patients who received CDT at 2-year follow-up. The 5-year follow-up results from the trial has recently been published, which revealed persistent clinical benefit of CDT. Since, additional small randomized trials confer the efficacy and safety profile of CDT. Short-term results from pharmacomechanical catheter-directed thrombolysis are promising; however, the long-term efficacy has yet to be established. The recently completed Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis trial will be a pivotal study in defining the future role of pharmacomechanical catheter-directed thrombolysis in prevention of PTS. Summary CDT is a reasonable and well tolerated treatment option in selected patients with acute proximal DVT.