Thrombolysis for lower extremity deep venous thrombosis

Techniques in Vascular and Interventional Radiology
C P SembaM D Dake

Abstract

Catheter-directed thrombolysis (CDT) has been proposed as an alternative mode of therapy to anticoagulation in patients with massive, symptomatic deep vein thrombosis of the extremity. The major goal of therapy is to rapidly restore venous blood flow, reduce the pain and edema of the extremity, preserve venous valve function, and reduce chronic symptoms related to chronic venous hypertension (postthrombotic syndrome). In patients with iliofemoral deep venous thrombosis (DVT) standard angiographic techniques are used to instrument a lower extremity vein (popliteal) and venography is performed followed by catheter-directed infusion of a plasminogen activator directly into the thrombus. Following lytic infusion, the interventionalist must evaluate the venous drainage to determine if there is an anatomic lesion that requires further endovascular treatment (eg, iliac vein compression syndrome). Posttreatment therapy usually consists of warfarin therapy and venous compression stockings for at least 3 to 6 months. The purpose of this article is to review the technical approach used in treating iliofemoral DVT and highlight the hurdles that face interventionalists in attempting to broaden this procedure to most types of lower extremity...Continue Reading

Citations

Sep 1, 2007·Seminars in Interventional Radiology·Bulent ArslanAlan H Matsumoto
Dec 10, 2019·International Angiology : a Journal of the International Union of Angiology·Stephen A BlackChung S Lim
Jun 18, 2011·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Denise E DoomernikMichel M P J Reijnen
May 2, 2014·Current Cardiology Reports·Mahmood K Razavi, Emmad Karmouta
Jul 1, 2010·Journal of Thrombosis and Haemostasis : JTH·E M WysokinskaR D McBane Ii
Feb 26, 2016·Vascular and Endovascular Surgery·Nam Yeol YimHye Doo Jung
Jan 28, 2012·Journal of Huazhong University of Science and Technology. Medical Sciences = Hua Zhong Ke Ji Da Xue Xue Bao. Yi Xue Ying De Wen Ban = Huazhong Keji Daxue Xuebao. Yixue Yingdewen Ban·Yong WeiWanhua Yang

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