Title:Invasive and Pharmacological Treatment of Deep Vein Thrombosis: A Scoping
Review
Volume: 28
Issue: 10
Author(s): Marios Sagris*, Andreas Tzoumas, Damianos G. Kokkinidis, Grigorios Korosoglou, Michael Lichtenberg and Georgios Tzavellas
Affiliation:
- Department of Medicine, General Hospital of Nikaia, Piraeus, Athens, Greece
Keywords:
Deep vein thrombosis, DVT, Venous thromboembolism, pharmacological treatment, thrombolysis, Invasive treatment, Endovascular treatment, catheter-directed thrombolysis.
Abstract: The annual occurrence of venous thromboembolism (VTE) is 300,000-600,000 cases in the United
States and 700,000 in Europe. VTE includes deep venous thrombosis (DVT) of upper or lower extremities, superior
and inferior vena cava thrombosis, and pulmonary embolism (PE) as well. The primary treatment of
DVT includes oral anticoagulation to prevent the progression of the thrombus and decrease the risk of pulmonary
embolism. Depending on the symptoms, more invasive treatments can be applied to target the iliofemoral
thrombus and its removal. However, less emphasis is given to acute symptomatology, early recovery of function,
quality of life improvement, and the individualized likelihood of developing post-thrombotic syndrome.
While invasive therapy has been used to enhance the acute management of iliofemoral DVT, our knowledge
about the overall outcomes associated with the invasive treatment of VTE is still limited. In this review, we illustrate
the available data on pharmacological and endovascular management of iliofemoral VTE, including
therapies such as catheter-directed thrombolysis (CDT), mechanical thrombectomy (PMT), and pharmacomechanical
catheter-directed thrombolysis (PCDT).