Interventional Therapy of Deep Venous Thrombosis

  • Mohamad Akram Kawsara
  • Farhan Raza
  • Riyaz Bashir
  • Mohamad Alkhouli
Chapter

Abstract

Venous thromboembolism is the third most prevalent type of cardiovascular disease, behind coronary artery disease and stroke. Patients with deep vein thrombosis may suffer from advanced post-thrombotic syndrome and other life-threatening complications such as pulmonary embolism and phlegmasia cerulea dolens. Intravenous anticoagulation has been the mainstay therapy for deep vein thrombosis, with proven efficacy in reducing the risk of pulmonary embolism and alleviating acute symptoms. However, the efficacy of anticoagulation in treating severe cases and preventing post-thrombotic syndrome is questionable at best. The marked improvement in catheter-based techniques over the last two decades led to a mounting interest and widespread utilization of catheter-based interventions in the treatment of deep venous thrombosis. Early studies suggest that percutaneous thrombus removal modalities can be a successful primary treatment for selected patients with deep venous thrombosis and it may prevent post-thrombotic syndrome.

References

  1. 1.
    Goldhaber SZ, Bounameaux H. Pulmonary embolism and deep vein thrombosis. Lancet. 2012;379(9828):1835–46.CrossRefPubMedGoogle Scholar
  2. 2.
    Beckman MG, et al. Venous thromboembolism: a public health concern. Am J Prev Med. 2010;38(4 Suppl):S495–501.CrossRefPubMedGoogle Scholar
  3. 3.
    Grosse SD. Incidence-based cost estimates require population-based incidence data. A critique of Mahan et al. Thromb Haemost. 2012;107(1):192–3. author reply 194-5CrossRefPubMedGoogle Scholar
  4. 4.
    Reporting standards in venous disease. Prepared by the subcommittee on reporting standards in venous disease, Ad Hoc committee on reporting standards, society for vascular surgery/North American Chapter, International Society for Cardiovascular Surgery. J Vasc Surg. 1988;8(2):172–81.CrossRefGoogle Scholar
  5. 5.
    Alkhouli M, et al. Comparative outcomes of catheter-directed thrombolysis plus anticoagulation versus anticoagulation alone in the treatment of inferior vena caval thrombosis. Circ Cardiovasc Interv. 2015;8(2):e001882.CrossRefPubMedGoogle Scholar
  6. 6.
    Bashir R, et al. Comparative outcomes of catheter-directed thrombolysis plus anticoagulation vs anticoagulation alone to treat lower-extremity proximal deep vein thrombosis. JAMA Intern Med. 2014;174(9):1494–501.CrossRefPubMedGoogle Scholar
  7. 7.
    Okrent D, Messersmith R, Buckman J. Transcatheter fibrinolytic therapy and angioplasty for left iliofemoral venous thrombosis. J Vasc Interv Radiol. 1991;2(2):195–7; discussion 198-200CrossRefPubMedGoogle Scholar
  8. 8.
    Semba CP, Dake MD. Iliofemoral deep venous thrombosis: aggressive therapy with catheter-directed thrombolysis. Radiology. 1994;191(2):487–94.CrossRefPubMedGoogle Scholar
  9. 9.
    Sharafuddin MJ, et al. Endovascular management of venous thrombotic and occlusive diseases of the lower extremities. J Vasc Interv Radiol. 2003;14(4):405–23.CrossRefPubMedGoogle Scholar
  10. 10.
    Verhaeghe R, et al. Catheter-directed lysis of iliofemoral vein thrombosis with use of rt-PA. Eur Radiol. 1997;7(7):996–1001.CrossRefPubMedGoogle Scholar
  11. 11.
    Engelberger RP, Kucher N. Management of deep vein thrombosis of the upper extremity. Circulation. 2012;126(6):768–73.CrossRefPubMedGoogle Scholar
  12. 12.
    Moheimani F, Jackson DE. Venous thromboembolism: classification, risk factors, diagnosis, and management. ISRN Hematol. 2011;2011:124610.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Nicolaides AN, et al. Myocardial infarction and deep-vein thrombosis. Br Med J. 1971;1(5746):432–4.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Alkhouli M, et al. Inferior vena cava thrombosis. JACC Cardiovasc Interv. 2016;9(7):629–43.CrossRefPubMedGoogle Scholar
  15. 15.
    Kucher N. Clinical practice. Deep-vein thrombosis of the upper extremities. N Engl J Med. 2011;364(9):861–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Kearon C, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016;149(2):315–52.CrossRefPubMedGoogle Scholar
  17. 17.
    Neglen P, et al. Surgical removal of an inferior vena cava thrombus. Eur J Vasc Surg. 1992;6(1):78–82.CrossRefPubMedGoogle Scholar
  18. 18.
    Arnesen H, Hoiseth A, Ly B. Streptokinase of heparin in the treatment of deep vein thrombosis. Follow-up results of a prospective study. Acta Med Scand. 1982;211(1–2):65–8.PubMedGoogle Scholar
  19. 19.
    Plate G, et al. Venous thrombectomy for iliofemoral vein thrombosis – 10-year results of a prospective randomised study. Eur J Vasc Endovasc Surg. 1997;14(5):367–74.CrossRefPubMedGoogle Scholar
  20. 20.
    Elliot MS, et al. A comparative randomized trial of heparin versus streptokinase in the treatment of acute proximal venous thrombosis: an interim report of a prospective trial. Br J Surg. 1979;66(12):838–43.CrossRefPubMedGoogle Scholar
  21. 21.
    Meissner MH, et al. 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. 2012;55(5):1449–62.CrossRefPubMedGoogle Scholar
  22. 22.
    de Araujo Bessa JC. Femoral and iliofemoral thrombectomy to prevent chronic venous insufficiency. Follow-up of 18 patients. J Cardiovasc Surg. 1986;27(4):443–6.Google Scholar
  23. 23.
    Roder OC, Lorentzen JE, Hansen HJ. Venous thrombectomy for iliofemoral thrombosis. Early and long-term results in 46 consecutive cases. Acta Chir Scand. 1984;150(1):31–4.PubMedGoogle Scholar
  24. 24.
    Comerota AJ. Quality-of-life improvement using thrombolytic therapy for iliofemoral deep venous thrombosis. Rev Cardiovasc Med. 2002;3(Suppl 2):S61–7.PubMedGoogle Scholar
  25. 25.
    Erdoes LS, et al. Pharmacomechanical thrombolysis for phlegmasia cerulea dolens. Am Surg. 2011;77(12):1606–12.PubMedGoogle Scholar
  26. 26.
    Park SI, et al. Single-session aspiration thrombectomy of lower extremity deep vein thrombosis using large-size catheter without pharmacologic thrombolysis. Cardiovasc Intervent Radiol. 2014;37(2):412–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Enden T, et al. 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. 2012;379(9810):31–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Casey ET, et al. Treatment of acute iliofemoral deep vein thrombosis. J Vasc Surg. 2012;55(5):1463–73.CrossRefPubMedGoogle Scholar
  29. 29.
    Dasari TW, Pappy R, Hennebry TA. Pharmacomechanical thrombolysis of acute and chronic symptomatic deep vein thrombosis: a systematic review of literature. Angiology. 2012;63(2):138–45.CrossRefPubMedGoogle Scholar
  30. 30.
    Dumantepe M, Tarhan IA, Ozler A. Treatment of chronic deep vein thrombosis using ultrasound accelerated catheter-directed thrombolysis. Eur J Vasc Endovasc Surg. 2013;46(3):366–71.CrossRefPubMedGoogle Scholar
  31. 31.
    Manninen H, et al. Catheter-directed thrombolysis of proximal lower extremity deep vein thrombosis: a prospective trial with venographic and clinical follow-up. Eur J Radiol. 2012;81(6):1197–202.CrossRefPubMedGoogle Scholar
  32. 32.
    Srinivas BC, et al. Catheter-directed thrombolysis along with mechanical thromboaspiration versus anticoagulation alone in the management of lower limb deep venous thrombosis-a comparative study. Int J Angiol. 2014;23(4):247–54.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Vedantham S. Catheter-directed thrombolysis for deep vein thrombosis. Curr Opin Hematol. 2010;17(5):464–8.CrossRefPubMedGoogle Scholar
  34. 34.
    Elsharawy M, Elzayat E. Early results of thrombolysis vs anticoagulation in iliofemoral venous thrombosis. A randomised clinical trial. Eur J Vasc Endovasc Surg. 2002;24(3):209–14.CrossRefPubMedGoogle Scholar
  35. 35.
    Sharifi M, et al. Endovenous therapy for deep venous thrombosis: the TORPEDO trial. Catheter Cardiovasc Interv. 2010;76(3):316–25.CrossRefPubMedGoogle Scholar
  36. 36.
    Vedantham S, et al. Rationale and design of the ATTRACT Study: a multicenter randomized trial to evaluate pharmacomechanical catheter-directed thrombolysis for the prevention of postthrombotic syndrome in patients with proximal deep vein thrombosis. Am Heart J. 2013;165(4):523–30 e3.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Robinson DL, Teitelbaum GP. Phlegmasia cerulea dolens: treatment by pulse-spray and infusion thrombolysis. AJR Am J Roentgenol. 1993;160(6):1288–90.CrossRefPubMedGoogle Scholar
  38. 38.
    AbuRahma AF, et al. Iliofemoral deep vein thrombosis: conventional therapy versus lysis and percutaneous transluminal angioplasty and stenting. Ann Surg. 2001;233(6):752–60.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Jaff MR, et al. 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. 2011;123(16):1788–830.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Mewissen MW, et al. Catheter-directed thrombolysis for lower extremity deep venous thrombosis: report of a national multicenter registry. Radiology. 1999;211(1):39–49.CrossRefPubMedGoogle Scholar
  41. 41.
    Martin M, Fiebach BJ. Short-term ultrahigh streptokinase treatment of chronic arterial occlusions and acute deep vein thromboses. Semin Thromb Hemost. 1991;17(1):21–38.CrossRefPubMedGoogle Scholar
  42. 42.
    Theiss W, et al. The success rate of fibrinolytic therapy in fresh and old thrombosis of the iliac and femoral veins. Angiology. 1983;34(1):61–9.CrossRefPubMedGoogle Scholar
  43. 43.
    Vedantham S, et al. Quality improvement guidelines for the treatment of lower-extremity deep vein thrombosis with use of endovascular thrombus removal. J Vasc Interv Radiol. 2014;25(9):1317–25.CrossRefPubMedGoogle Scholar
  44. 44.
    Vedantham S, et al. Quality improvement guidelines for the treatment of lower extremity deep vein thrombosis with use of endovascular thrombus removal. J Vasc Interv Radiol. 2009;20(7 Suppl):S227–39.CrossRefPubMedGoogle Scholar
  45. 45.
    Owens CA. Ultrasound-enhanced thrombolysis: EKOS EndoWave infusion catheter system. Semin Intervent Radiol. 2008;25(1):37–41.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Chernysh IN, et al. Molecular mechanisms of the effect of ultrasound on the fibrinolysis of clots. J Thromb Haemost. 2015;13(4):601–9.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Engelberger RP, et al. Ultrasound-assisted versus conventional catheter-directed thrombolysis for acute iliofemoral deep vein thrombosis. Circ Cardiovasc Interv. 2015;8(1):e002027.CrossRefPubMedGoogle Scholar
  48. 48.
    Baker R, et al. Ultrasound-accelerated vs standard catheter-directed thrombolysis – a comparative study in patients with iliofemoral deep vein thrombosis. J Vasc Interv Radiol. 2012;23(11):1460–6.CrossRefPubMedGoogle Scholar
  49. 49.
    Hold M, et al. Deep venous thrombosis: results of thrombectomy versus medical therapy. Presented at the 5th European-American Symposium on Venous Diseases, Vienna, Austria, 1990. Vasa. 1992;21(2):181–7.PubMedGoogle Scholar
  50. 50.
    Arko FR, et al. Aggressive percutaneous mechanical thrombectomy of deep venous thrombosis: early clinical results. Arch Surg. 2007;142(6):513–8; discussion 518-9CrossRefPubMedGoogle Scholar
  51. 51.
    Grunwald MR, Hofmann LV. Comparison of urokinase, alteplase, and reteplase for catheter-directed thrombolysis of deep venous thrombosis. J Vasc Interv Radiol. 2004;15(4):347–52.CrossRefPubMedGoogle Scholar
  52. 52.
    Semba CP, et al. Alteplase as an alternative to urokinase. Advisory Panel on Catheter-Directed Thrombolytic Therapy. J Vasc Interv Radiol. 2000;11(3):279–87.CrossRefPubMedGoogle Scholar
  53. 53.
    Semba CP, et al. Alteplase and tenecteplase: applications in the peripheral circulation. Tech Vasc Interv Radiol. 2001;4(2):99–106.CrossRefPubMedGoogle Scholar
  54. 54.
    Sugimoto K, et al. The safety, efficacy, and pharmacoeconomics of low-dose alteplase compared with urokinase for catheter-directed thrombolysis of arterial and venous occlusions. J Vasc Surg. 2003;37(3):512–7.CrossRefPubMedGoogle Scholar
  55. 55.
    Bjarnason H, et al. Iliofemoral deep venous thrombosis: safety and efficacy outcome during 5 years of catheter-directed thrombolytic therapy. J Vasc Interv Radiol. 1997;8(3):405–18.CrossRefPubMedGoogle Scholar
  56. 56.
    Grossman C, McPherson S. Safety and efficacy of catheter-directed thrombolysis for iliofemoral venous thrombosis. AJR Am J Roentgenol. 1999;172(3):667–72.CrossRefPubMedGoogle Scholar
  57. 57.
    Ouriel K, et al. Complications associated with the use of urokinase and recombinant tissue plasminogen activator for catheter-directed peripheral arterial and venous thrombolysis. J Vasc Interv Radiol. 2000;11(3):295–8.CrossRefPubMedGoogle Scholar
  58. 58.
    Lorch H, et al. Current practice of temporary vena cava filter insertion: a multicenter registry. J Vasc Interv Radiol. 2000;11(1):83–8.CrossRefPubMedGoogle Scholar
  59. 59.
    Tarry WC, et al. Catheter-directed thrombolysis following vena cava filtration for severe deep venous thrombosis. Ann Vasc Surg. 1994;8(6):583–90.CrossRefPubMedGoogle Scholar
  60. 60.
    Parikh S, et al. Ultrasound-accelerated thrombolysis for the treatment of deep vein thrombosis: initial clinical experience. J Vasc Interv Radiol. 2008;19(4):521–8.CrossRefPubMedGoogle Scholar
  61. 61.
    Moriarty JM, et al. Removal of caval and right atrial thrombi and masses using the AngioVac device: initial operative experience. J Vasc Interv Radiol. 2016;27(10):1584–91.CrossRefPubMedGoogle Scholar
  62. 62.
    Resnick SA, et al. Single-center experience using AngioVac with extracorporeal bypass for mechanical thrombectomy of atrial and central vein thrombi. J Vasc Interv Radiol. 2016;27(5):723–9. e1CrossRefPubMedGoogle Scholar
  63. 63.
    Neglen P, et al. Bilateral stenting at the iliocaval confluence. J Vasc Surg. 2010;51(6):1457–66.CrossRefPubMedGoogle Scholar
  64. 64.
    Neglen P, et al. Stenting of chronically obstructed inferior vena cava filters. J Vasc Surg. 2011;54(1):153–61.CrossRefPubMedGoogle Scholar
  65. 65.
    Kolbel T, et al. Thrombus embolization into IVC filters during catheter-directed thrombolysis for proximal deep venous thrombosis. J Endovasc Ther. 2008;15(5):605–13.CrossRefPubMedGoogle Scholar
  66. 66.
    Protack CD, et al. Long-term outcomes of catheter directed thrombolysis for lower extremity deep venous thrombosis without prophylactic inferior vena cava filter placement. J Vasc Surg. 2007;45(5):992–7. discussion 997CrossRefPubMedGoogle Scholar
  67. 67.
    Agnelli G, et al. Oral apixaban for the treatment of acute venous thromboembolism. N Engl J Med. 2013;369(9):799–808.CrossRefPubMedGoogle Scholar
  68. 68.
    Hokusai VTEI, et al. Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism. N Engl J Med. 2013;369(15):1406–15.CrossRefGoogle Scholar
  69. 69.
    Investigators E, et al. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med. 2010;363(26):2499–510.CrossRefGoogle Scholar
  70. 70.
    Kahn SR, et al. Compression stockings to prevent post-thrombotic syndrome: a randomised placebo-controlled trial. Lancet. 2014;383(9920):880–8.CrossRefPubMedGoogle Scholar
  71. 71.
    Elman EE, Kahn SR. The post-thrombotic syndrome after upper extremity deep venous thrombosis in adults: a systematic review. Thromb Res. 2006;117(6):609–14.CrossRefPubMedGoogle Scholar
  72. 72.
    Roumen-Klappe EM, et al. The post-thrombotic syndrome: incidence and prognostic value of non-invasive venous examinations in a six-year follow-up study. Thromb Haemost. 2005;94(4):825–30.PubMedGoogle Scholar
  73. 73.
    Maleux G, et al. Catheter-directed thrombolytic therapy for thoracic deep vein thrombosis is safe and effective in selected patients with and without cancer. Eur Radiol. 2010;20(9):2293–300.CrossRefPubMedGoogle Scholar
  74. 74.
    Enden T, et al. 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. 2009;7(8):1268–75.CrossRefPubMedGoogle Scholar
  75. 75.
    Munoz FJ, et al. Clinical outcome of patients with upper-extremity deep vein thrombosis: results from the RIETE Registry. Chest. 2008;133(1):143–8.CrossRefPubMedGoogle Scholar
  76. 76.
    Chaudhry MA, Pappy R, Hennebry TA. Use of the trellis device in the management of deep vein thrombosis: a retrospective single-center experience. J Invasive Cardiol. 2013;25(6):296–9.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mohamad Akram Kawsara
    • 1
  • Farhan Raza
    • 2
  • Riyaz Bashir
    • 2
  • Mohamad Alkhouli
    • 1
  1. 1.Department of Cardiovascular DiseaseWest Virginia UniversityMorgantownUSA
  2. 2.Division of Cardiovascular DiseasesTemple University School of MedicinePhiladelphiaUSA

Personalised recommendations