Skip to main content
SpringerLink
Log in

Interventional Treatment of Deep Vein Thrombosis

  • Reference work entry
  • First Online:
PanVascular Medicine

  • 218 Accesses

Abstract

Patients with iliofemoral deep vein thrombosis (DVT) are at high risk of developing the post-thrombotic syndrome (PTS). Early thrombus removal strategies including systemic thrombolysis, surgical thrombectomy, or catheter-based interventions have been shown to reduce the incidence of PTS in patients with iliofemoral DVT. Catheter-based interventional treatments are particularly attractive because of their minimal invasive character and small bleeding risk. The present chapter summarizes the currently used techniques and the available evidence to support the use of this treatment modality in selected patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 649.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 549.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

Catheter-directed thrombolysis (CDT):

Intra-thrombus administration of a thrombolytic drug through a multi-sidehole catheter.

Pharmaco-mechanical thrombolysis (PMT):

Combination of CDT with percutaneous mechanical thrombectomy.

References

  • Braaten JV, Goss RA, Francis CW (1997) Ultrasound reversibly disaggregates fibrin fibers. Thromb Haemost 78(3):1063–1068

    CAS  PubMed  Google Scholar 

  • Chung JW, Yoon CJ, Jung SI, Kim HC, Lee W, Kim YI, Jae HJ, Park JH (2004) Acute iliofemoral deep vein thrombosis: evaluation of underlying anatomic abnormalities by spiral CT venography. J Vasc Interv Radiol 15(3):249–256

    Article  PubMed  Google Scholar 

  • Comerota AJ (2012) The current role of operative venous thrombectomy in deep vein thrombosis. Semin Vasc Surg 25(1):2–12

    Article  PubMed  Google Scholar 

  • Enden T, Klow NE, Sandvik L, Slagsvold CE, Ghanima W, Hafsahl G, Holme PA, Holmen LO, Njaastad AM, Sandbaek G, Sandset PM (2009) Catheter-directed thrombolysis vs. anticoagulant therapy alone in deep vein thrombosis: results of an open randomized, controlled trial reporting on short-term patency. J Thromb Haemost 7(8):1268–1275

    Article  CAS  PubMed  Google Scholar 

  • Enden T, Haig Y, Klow NE, Slagsvold CE, Sandvik L, Ghanima W, Hafsahl G, Holme PA, Holmen LO, Njaastad AM, Sandbaek G, Sandset PM (2012) Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet 379(9810):31–38

    Article  PubMed  Google Scholar 

  • Engelberger RP, Kucher N (2011) Catheter-based reperfusion treatment of pulmonary embolism. Circulation 124(19):2139–2144

    Article  PubMed  Google Scholar 

  • Fahrni J, Engelberger RP, Kucher N, Willenberg T, Baumgartner I (2013) Catheter-based treatment of ilio-femoral deep vein thrombosis – an update on current evidence. Vasa 42(3):161–167

    Article  PubMed  Google Scholar 

  • Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ, Jenkins JS, Kline JA, Michaels AD, Thistlethwaite P, Vedantham S, White RJ, Zierler BK (2011) Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation 123(16):1788–1830

    Article  PubMed  Google Scholar 

  • Kahn SR, Shrier I, Julian JA, Ducruet T, Arsenault L, Miron MJ, Roussin A, Desmarais S, Joyal F, Kassis J, Solymoss S, Desjardins L, Lamping DL, Johri M, Ginsberg JS (2008) Determinants and time course of the postthrombotic syndrome after acute deep venous thrombosis. Ann Intern Med 149(10):698–707

    Article  PubMed  Google Scholar 

  • Karthikesalingam A, Young EL, Hinchliffe RJ, Loftus IM, Thompson MM, Holt PJ (2011) A systematic review of percutaneous mechanical thrombectomy in the treatment of deep venous thrombosis. Eur J Vasc Endovasc Surg 41(4):554–565

    Article  CAS  PubMed  Google Scholar 

  • Kearon C, Akl EA, Comerota AJ, Prandoni P, Bounameaux H, Goldhaber SZ, Nelson ME, Wells PS, Gould MK, Dentali F, Crowther M, Kahn SR (2012) Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed, American College of Chest Physicians evidence-based clinical practice guidelines. Chest 141(2 suppl):e419S–e494S

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kim HS, Patra A, Paxton BE, Khan J, Streiff MB (2006) Catheter-directed thrombolysis with percutaneous rheolytic thrombectomy versus thrombolysis alone in upper and lower extremity deep vein thrombosis. Cardiovasc Intervent Radiol 29(6):1003–1007

    Article  PubMed  Google Scholar 

  • Lichtenberg M, Stahlhoff FW, Boese D (2013) Endovascular treatment of acute limb ischemia and proximal deep vein thrombosis using rotational thrombectomy: a review of published literature. Cardiovasc Revasc Med 14(6):343–348

    Article  PubMed  Google Scholar 

  • Lin PH, Zhou W, Dardik A, Mussa F, Kougias P, Hedayati N, Naoum JJ, El Sayed H, Peden EK, Huynh TT (2006) Catheter-direct thrombolysis versus pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis. Am J Surg 192(6):782–788

    Article  PubMed  Google Scholar 

  • Mair DC, Eastlund T, Rosen G, Covin R, Harmon JV, Menser M, Carr R, Shrwany S (2005) Hemolysis during percutaneous mechanical thrombectomy can mimic a hemolytic transfusion reaction. Transfusion 45(8):1291–1294

    Article  CAS  PubMed  Google Scholar 

  • Meissner MH, Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Lohr JM, McLafferty RB, Murad MH, Padberg F, Pappas P, Raffetto JD, Wakefield TW (2012) Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 55(5):1449–1462

    Article  PubMed  Google Scholar 

  • Meyerovitz MF, Polak JF, Goldhaber SZ (1992) Short-term response to thrombolytic therapy in deep venous thrombosis: predictive value of venographic appearance. Radiology 184(2):345–348

    Article  CAS  PubMed  Google Scholar 

  • O’Sullivan GJ, Lohan DG, Gough N, Cronin CG, Kee ST (2007) Pharmacomechanical thrombectomy of acute deep vein thrombosis with the Trellis-8 isolated thrombolysis catheter. J Vasc Interv Radiol 18(6):715–724

    Article  PubMed  Google Scholar 

  • Parikh S, Motarjeme A, McNamara T, Raabe R, Hagspiel K, Benenati JF, Sterling K, Comerota A (2008) Ultrasound-accelerated thrombolysis for the treatment of deep vein thrombosis: initial clinical experience. J Vasc Interv Radiol 19(4):521–528

    Article  PubMed  Google Scholar 

  • Popuri RK, Vedantham S (2011) The role of thrombolysis in the clinical management of deep vein thrombosis. Arterioscler Thromb Vasc Biol 31(3):479–484

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Prandoni P, Frulla M, Sartor D, Concolato A, Girolami A (2005) Vein abnormalities and the post-thrombotic syndrome. J Thromb Haemost 3(2):401–402

    Article  CAS  PubMed  Google Scholar 

  • Rao AS, Konig G, Leers SA, Cho J, Rhee RY, Makaroun MS, Chaer RA (2009) Pharmacomechanical thrombectomy for iliofemoral deep vein thrombosis: an alternative in patients with contraindications to thrombolysis. J Vasc Surg 50(5):1092–1098

    Article  PubMed  Google Scholar 

  • Sharifi M, Bay C, Mehdipour M, Sharifi J (2012) Thrombus Obliteration by Rapid Percutaneous Endovenous Intervention in Deep Venous Occlusion (TORPEDO) trial: midterm results. J Endovasc Ther 19(2):273–280

    Article  PubMed  Google Scholar 

  • Watson LI, Armon MP (2004) Thrombolysis for acute deep vein thrombosis. Cochrane Database Syst Rev 4, CD002783

    Google Scholar 

  • Zhu DW (2008) The potential mechanisms of bradyarrhythmias associated with AngioJet thrombectomy. J Invasive Cardiol 20(8 Suppl A):2A–4A

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Angiology, Swiss Cardiovascular Center, University Hospital and University of Bern, Bern, Switzerland

    Rolf P. Engelberger, Jennifer Fahrni, Torsten Willenberg & Nils Kucher

Authors
  1. Rolf P. Engelberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jennifer Fahrni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Torsten Willenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nils Kucher
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rolf P. Engelberger .

Editor information

Editors and Affiliations

  1. Division of Cardiovascular Disease Department of Internal Medicine, Health Care Center Bitterfeld, Bitterfeld-Wolfen, Germany

    Peter Lanzer

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Engelberger, R.P., Fahrni, J., Willenberg, T., Kucher, N. (2015). Interventional Treatment of Deep Vein Thrombosis. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_112

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-37078-6_112

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-37077-9

  • Online ISBN: 978-3-642-37078-6

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation