Endovascular Treatment Options in the Management of Lower Limb Deep Venous Thrombosis

• Published in: Cardiovascular and interventional radiology Vol. 32; no. 5; pp. 861 - 876
• Main Authors: Nazir, Sarfraz Ahmed, Ganeshan, Arul, Nazir, Sheraz, Uberoi, Raman
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.09.2009; Springer Nature B.V
• Subjects: Angioplasty - methods; Anticoagulants - administration & dosage; BLOOD VESSELS; BODY; Cardiology; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; Catheterization - methods; DISEASES; Humans; Imaging; Leg - blood supply; LIMBS; MANAGEMENT; MEDICINE; Medicine & Public Health; Minimally Invasive Surgical Procedures; Nuclear Medicine; ORGANS; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Review; Stents; THERAPY; Thrombectomy - methods; Thrombolytic Therapy - methods; THROMBOSIS; Ultrasound; VASCULAR DISEASES; VEINS; Vena Cava Filters; Venous Thrombosis - therapy; Deep venous thrombosis; Percutaneous mechanical thrombectomy; Endovascular; Catheter-directed thrombolysis; Inferior vena cava filters
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-009-9662-z

Lower limb deep vein thrombosis (DVT) is a common cause of significant morbidity and mortality. Systemic anticoagulation therapy is the mainstay of conventional treatment instituted by most physicians for the management of DVT. This has proven efficacy in the prevention of thrombus extension and reduction in the incidence of pulmonary embolism and rethrombosis. Unfortunately, especially in patients with severe and extensive iliofemoral DVT, standard treatment may not be entirely adequate. This is because a considerable proportion of these patients eventually develops postthrombotic syndrome. This is characterized by chronic extremity pain and trophic skin changes, edema, ulceration, and venous claudication. Recent interest in endovascular technologies has led to the development of an assortment of minimally invasive, catheter-based strategies to deal with venous thrombus. These comprise catheter-directed thrombolysis, percutaneous mechanical thrombectomy devices, adjuvant venous angioplasty and stenting, and inferior vena cava filters. This article reviews these technologies and discusses their current role as percutaneous treatment strategies for venous thrombotic conditions.