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Semin Thromb Hemost 2013; 39(04): 446-451
DOI: 10.1055/s-0033-1334142
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Catheter-Directed Thrombolysis of Deep Venous Thrombosis

Rahmi Oklu
1   Division of Vascular Imaging and Intervention, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
,
Stephan Wicky
1   Division of Vascular Imaging and Intervention, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
› Author Affiliations
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Publication History

Publication Date:
12 March 2013 (online)

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Abstract

Venous thrombosis is a major public health problem associated with significant morbidity and mortality and has a substantial impact on the quality of life. Over the years, it has become more apparent that anticoagulation alone in the treatment of deep venous thrombosis (DVT) is insufficient in the prevention of postthrombotic syndrome, which adversely impacts the quality of life of the patient, and it is insufficient in preventing recurrence of DVT. With the advent of innovative catheter designs to deliver thrombolytic therapies in the treatment of DVT, there have been significant advances in the management of DVT. We review the management of DVT with emphasis on catheter-directed interventions.

Keywords

thrombosis - catheter-directed thrombolysis - vein - DVT
 

  • References

  • 1 Beckman MG, Hooper WC, Critchley SE, Ortel TL. Venous thromboembolism: a public health concern. Am J Prev Med 2010; 38 (4, Suppl) S495-S501
    CrossrefPubMedGoogle Scholar
  • 2 Wiener RS, Schwartz LM, Woloshin S. Time trends in pulmonary embolism in the United States: evidence of overdiagnosis. Arch Intern Med 2011; 171 (9) 831-837
    CrossrefPubMedGoogle Scholar
  • 3 Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin 2011; 61 (4) 212-236
    CrossrefPubMedGoogle Scholar
  • 4 National Highway and Traffic Safety Association Fatality Analysis Reporting System (FARS) Available at: http://www-farsnhtsadotgov . Accessed November 29, 2012
    PubMed
  • 5 Raju S, Fountain T, Neglén P, Devidas M. Axial transformation of the profunda femoris vein. J Vasc Surg 1998; 27 (4) 651-659
    CrossrefPubMedGoogle Scholar
  • 6 Snow V, Qaseem A, Barry P , et al; American College of Physicians; American Academy of Family Physicians Panel on Deep Venous Thrombosis/Pulmonary Embolism. Management of venous thromboembolism: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med 2007; 146 (3) 204-210
    CrossrefPubMedGoogle Scholar
  • 7 Prandoni P, Lensing AW, Prins MH , et al. Residual venous thrombosis as a predictive factor of recurrent venous thromboembolism. Ann Intern Med 2002; 137 (12) 955-960
    CrossrefPubMedGoogle Scholar
  • 8 Henke PK, Comerota AJ. An update on etiology, prevention, and therapy of postthrombotic syndrome. J Vasc Surg 2011; 53 (2) 500-509
    CrossrefPubMedGoogle Scholar
  • 9 Prandoni P, Frulla M, Sartor D, Concolato A, Girolami A. Vein abnormalities and the post-thrombotic syndrome. J Thromb Haemost 2005; 3 (2) 401-402
    CrossrefPubMedGoogle Scholar
  • 10 Jaff MR, McMurtry MS, Archer SL , et al; American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; American Heart Association Council on Peripheral Vascular Disease; American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology. 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) 1788-1830
    CrossrefPubMedGoogle Scholar
  • 11 Vedantham S, Grassi CJ, Ferral H , et al; Technology Assessment Committee of the Society of Interventional Radiology. Reporting standards for endovascular treatment of lower extremity deep vein thrombosis. J Vasc Interv Radiol 2009; 20 (7) (Suppl): S391-S408
    CrossrefPubMedGoogle Scholar
  • 12 Vedantham S, Millward SF, Cardella JF , et al. Society of Interventional Radiology position statement: treatment of acute iliofemoral deep vein thrombosis with use of adjunctive catheter-directed intrathrombus thrombolysis. J Vasc Interv Radiol 2009; 20 (7) (Suppl): S332-S335
    CrossrefPubMedGoogle Scholar
  • 13 Vedantham S, Thorpe PE, Cardella JF , et al; CIRSE and SIR Standards of Practice Committees. 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-S239
    CrossrefPubMedGoogle Scholar
  • 14 Comerota AJ, Throm RC, Mathias SD, Haughton S, Mewissen M. Catheter-directed thrombolysis for iliofemoral deep venous thrombosis improves health-related quality of life. J Vasc Surg 2000; 32 (1) 130-137
    CrossrefPubMedGoogle Scholar
  • 15 Hull RD, Marder VJ, Mah AF, Biel RK, Brant RF. Quantitative assessment of thrombus burden predicts the outcome of treatment for venous thrombosis: a systematic review. Am J Med 2005; 118 (5) 456-464
    CrossrefPubMedGoogle Scholar
  • 16 Meissner MH, Manzo RA, Bergelin RO, Markel A, Strandness Jr DE. Deep venous insufficiency: the relationship between lysis and subsequent reflux. J Vasc Surg 1993; 18 (4) 596-605 , discussion 606–608
    CrossrefPubMedGoogle Scholar
  • 17 Mewissen MW, Seabrook GR, Meissner MH, Cynamon J, Labropoulos N, Haughton SH. Catheter-directed thrombolysis for lower extremity deep venous thrombosis: report of a national multicenter registry. Radiology 1999; 211 (1) 39-49
    CrossrefPubMedGoogle Scholar
  • 18 Enden T, Haig Y, Kløw NE , et al; CaVenT Study Group. 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) 31-38
    CrossrefPubMedGoogle Scholar
  • 19 Kahn SR, Shrier I, Julian JA , et al. Determinants and time course of the postthrombotic syndrome after acute deep venous thrombosis. Ann Intern Med 2008; 149 (10) 698-707
    CrossrefPubMedGoogle Scholar
  • 20 Douketis JD, Crowther MA, Foster GA, Ginsberg JS. Does the location of thrombosis determine the risk of disease recurrence in patients with proximal deep vein thrombosis?. Am J Med 2001; 110 (7) 515-519
    CrossrefPubMedGoogle Scholar
  • 21 Akesson H, Brudin L, Dahlström JA, Eklöf B, Ohlin P, Plate G. Venous function assessed during a 5 year period after acute ilio-femoral venous thrombosis treated with anticoagulation. Eur J Vasc Surg 1990; 4 (1) 43-48
    CrossrefPubMedGoogle Scholar
  • 22 Delis KT, Bountouroglou D, Mansfield AO. Venous claudication in iliofemoral thrombosis: long-term effects on venous hemodynamics, clinical status, and quality of life. Ann Surg 2004; 239 (1) 118-126
    CrossrefPubMedGoogle Scholar
  • 23 Arnesen H, Høiseth 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) 65-68
    PubMedGoogle Scholar
  • 24 Elliot MS, Immelman EJ, Jeffery P , 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) 838-843
    CrossrefPubMedGoogle Scholar
  • 25 Goldhaber SZ, Buring JE, Lipnick RJ, Hennekens CH. Pooled analyses of randomized trials of streptokinase and heparin in phlebographically documented acute deep venous thrombosis. Am J Med 1984; 76 (3) 393-397
    CrossrefPubMedGoogle Scholar
  • 26 Goldhaber SZ, Meyerovitz MF, Green D , et al. Randomized controlled trial of tissue plasminogen activator in proximal deep venous thrombosis. Am J Med 1990; 88 (3) 235-240
    CrossrefPubMedGoogle Scholar
  • 27 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) 209-214
    CrossrefPubMedGoogle Scholar
  • 28 Enden T, Kløw NE, Sandvik L , et al; CaVenT study group. 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) 1268-1275
    CrossrefPubMedGoogle Scholar
  • 29 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) 347-352
    CrossrefPubMedGoogle Scholar
  • 30 Shortell CK, Queiroz R, Johansson M , et al. Safety and efficacy of limited-dose tissue plasminogen activator in acute vascular occlusion. J Vasc Surg 2001; 34 (5) 854-859
    CrossrefPubMedGoogle Scholar
  • 31 Sugimoto K, Hofmann LV, Razavi MK , 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) 512-517
    CrossrefPubMedGoogle Scholar
  • 32 Vedantham S, Thorpe PE, Cardella JF , et al. Quality improvement guidelines for the treatment of lower extremity deep vein thrombosis with use of endovascular thrombus removal. J Vasc Interv Radiol 2006; 17 (3) 435-447 , quiz 448
    CrossrefPubMedGoogle Scholar
  • 33 AbuRahma AF, Perkins SE, Wulu JT, Ng HK. Iliofemoral deep vein thrombosis: conventional therapy versus lysis and percutaneous transluminal angioplasty and stenting. Ann Surg 2001; 233 (6) 752-760
    CrossrefPubMedGoogle Scholar
  • 34 Patel N, Sacks D, Patel RI , et al; Society of Interventional Radiology Technology Assessment Committee. SIR reporting standards for the treatment of acute limb ischemia with use of transluminal removal of arterial thrombus. J Vasc Interv Radiol 2003; 14 (9 Pt 2) S453-S465
    CrossrefPubMedGoogle Scholar
  • 35 Arko FR, Davis III CM, Murphy EH , et al. Aggressive percutaneous mechanical thrombectomy of deep venous thrombosis: early clinical results. Arch Surg 2007; 142 (6) 513-518 , discussion 518–519
    CrossrefPubMedGoogle Scholar
  • 36 Cynamon J, Stein EG, Dym RJ, Jagust MB, Binkert CA, Baum RA. A new method for aggressive management of deep vein thrombosis: retrospective study of the power pulse technique. J Vasc Interv Radiol 2006; 17 (6) 1043-1049
    CrossrefPubMedGoogle Scholar
  • 37 Kim HS, Patra A, Paxton BE, Khan J, Streiff MB. Adjunctive percutaneous mechanical thrombectomy for lower-extremity deep vein thrombosis: clinical and economic outcomes. J Vasc Interv Radiol 2006; 17 (7) 1099-1104
    CrossrefPubMedGoogle Scholar
  • 38 Lin PH, Zhou W, Dardik A , et al. Catheter-direct thrombolysis versus pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis. Am J Surg 2006; 192 (6) 782-788
    CrossrefPubMedGoogle Scholar
  • 39 O'Sullivan GJ, Lohan DG, Gough N, Cronin CG, Kee ST. Pharmacomechanical thrombectomy of acute deep vein thrombosis with the Trellis-8 isolated thrombolysis catheter. J Vasc Interv Radiol 2007; 18 (6) 715-724
    CrossrefPubMedGoogle Scholar
  • 40 Rao AS, Konig G, Leers SA , et al. Pharmacomechanical thrombectomy for iliofemoral deep vein thrombosis: an alternative in patients with contraindications to thrombolysis. J Vasc Surg 2009; 50 (5) 1092-1098
    CrossrefPubMedGoogle Scholar
  • 41 Vedantham S, Vesely TM, Sicard GA , et al. Pharmacomechanical thrombolysis and early stent placement for iliofemoral deep vein thrombosis. J Vasc Interv Radiol 2004; 15 (6) 565-574
    CrossrefPubMedGoogle Scholar
  • 42 Vedantham S. Interventional approaches to deep vein thrombosis. Am J Hematol 2012; 87 (Suppl. 01) S113-S118
    CrossrefPubMedGoogle Scholar
  • 43 Parikh S, Motarjeme A, McNamara T , et al. Ultrasound-accelerated thrombolysis for the treatment of deep vein thrombosis: initial clinical experience. J Vasc Interv Radiol 2008; 19 (4) 521-528
    CrossrefPubMedGoogle Scholar
  • 44 Braaten JV, Goss RA, Francis CW. Ultrasound reversibly disaggregates fibrin fibers. Thromb Haemost 1997; 78 (3) 1063-1068
    PubMedGoogle Scholar
  • 45 Francis CW, Blinc A, Lee S, Cox C. Ultrasound accelerates transport of recombinant tissue plasminogen activator into clots. Ultrasound Med Biol 1995; 21 (3) 419-424
    CrossrefPubMedGoogle Scholar
  • 46 Ganguli S, Kalva S, Oklu R , et al. Efficacy of lower-extremity venous thrombolysis in the setting of congenital absence or atresia of the inferior vena cava. Cardiovasc Intervent Radiol 2012; 35 (5) 1053-1058
    CrossrefPubMedGoogle Scholar