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Catheter-directed thrombolysis for extensive iliofemoral deep vein thrombosis: review of literature and ongoing trials

Lookup NU author(s): Dr Aaron Liew

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Abstract

In patients with extensive lower limb deep vein thrombosis (DVT) that, typically, extends into the iliofemoral veins, catheter-directed thrombolysis (CDT) can achieve faster and more complete thrombus lysis as compared with systemic thrombolysis, while providing an acceptable safety profile through administration of lower doses of thrombolytic agents. Through a reduction in thrombus burden, CDT has the potential to mitigate the risk for post-thrombotic syndrome by restoring venous patency and preserving venous valve function. The efficacy of CDT may be improved by adjunctive approaches that include percutaneous mechanical thrombectomy, angioplasty with or without stenting, and ultrasound-assisted CDT. CDT may also have a specific therapeutic role in the management of iliofemoral DVT involving patients who are pregnant or with May-Thurner syndrome. This article summarizes the literature in this area and discusses recently completed and ongoing randomized trials on the use of CDT in patients with extensive lower limb DVT.

Publication metadata

Author(s): Liew A, Douketis J

Publication type: Review

Publication status: Published

Journal: Expert Review of Cardiovascular Therapy

Year: 2016

Volume: 14

Issue: 2

Pages: 189-200

Print publication date: 01/02/2016

Online publication date: 17/12/2015

Acceptance date: 13/11/2015

ISSN (print): 1477-9072

ISSN (electronic): 1744-8344

URL: http://dx.doi.org/10.1586/14779072.2016.1121096

DOI: 10.1586/14779072.2016.1121096

PubMed id: 26568115

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