Management of Chronic Deep Vein Thrombosis in Women

Abstract

Chronic deep vein thrombosis (DVT) affects hundreds of thousands of women in the United States. Chronic DVT can lead to pain, edema, venous ulcers, and varicosities. While there are limited data regarding the management of chronic DVT, several interventional radiology groups aggressively treat chronic DVT to aid patient symptom resolution. Recanalization of occluded veins and venous stenting re-establishes deep vein flow and decreases venous hypertension.

Keywords

Chronic Deep Vein Thrombosis - IVC stenting - venous stasis - interventional radiology

• References

• 1 Cushman M. Epidemiology and risk factors for venous thrombosis. Semin Hematol 2007; 44 (02) 62-69
• 2 Varma S. Deep venous thrombosis in a young woman. Medicine Update. API 2007; 436-440
• 3 Vandenbroucke JP, Koster T, Briët E, Reitsma PH, Bertina RM, Rosendaal FR. Increased risk of venous thrombosis in oral-contraceptive users who are carriers of factor V Leiden mutation. Lancet 1994; 344 (8935): 1453-1457
• 4 Robbins MR, Assi Z, Comerota AJ. Endovascular stenting to treat chronic long-segment inferior vena cava occlusion. J Vasc Surg 2005; 41 (01) 136-140
• 5 Vedantham S, Goldhaber SZ, Kahn SR. , 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 (04) 523-530.e3
• 6 Dasari TW, Pappy R, Hennebry TA. Pharmacomechanical thrombolysis of acute and chronic symptomatic deep vein thrombosis: a systematic review of literature. Angiology 2012; 63 (02) 138-145
• 7 Friedrich de Wolf MA, Arnoldussen CW, Grommes J. , et al. Minimally invasive treatment of chronic iliofemoral venous occlusive disease. J Vasc Surg Venous Lymphat Disord 2013; 1 (02) 146-153
• 8 Enden T, Haig Y, Kløw N-E. , 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
• 9 Hartung O, Loundou AD, Barthelemy P, Arnoux D, Boufi M, Alimi YS. Endovascular management of chronic disabling ilio-caval obstructive lesions: long-term results. Eur J Vasc Endovasc Surg 2009; 38 (01) 118-124
• 10 Murphy EH, Johns B, Varney E, Raju S. Endovascular management of chronic total occlusions of the inferior vena cava and iliac veins. J Vasc Surg Venous Lymphat Disord 2017; 5 (01) 47-59
• 11 Neglén P, Raju S. Balloon dilation and stenting of chronic iliac vein obstruction: technical aspects and early clinical outcome. J Endovasc Ther 2000; 7 (02) 79-91
• 12 Sonin AH, Mazer MJ, Powers TA. Obstruction of the inferior vena cava: a multiple-modality demonstration of causes, manifestations, and collateral pathways. Radiographics 1992; 12 (02) 309-322
• 13 Williams DM. Iliocaval reconstruction in chronic deep vein thrombosis. Tech Vasc Interv Radiol 2014; 17 (02) 109-113
• 14 Hardman RL, Rochon PJ. Role of interventional radiologists in the management of lower extremity venous insufficiency. Semin Intervent Radiol 2013; 30 (04) 388-393
• 15 Practical Guidelines and Standards for Performance of the Peripheral Venous Ultrasound Examination. Reston, VA: American College of Cardiology; 2006
• 16 Karande GY, Hedgire SS, Sanchez Y. , et al. Advanced imaging in acute and chronic deep vein thrombosis. Cardiovasc Diagn Ther 2016; 6 (06) 493-507
• 17 Grilli C, McGarry M, Ali M. , et al. Abstract No. 290: Aggressive management of chronic deep venous thrombosis: technical and clinical outcomes. J Vasc Interv Radiol 2012; 23: S117-S118
• 18 Stanley GA, Murphy EH, Plummer MM, Chung J, Modrall JG, Arko III FR. Midterm results of percutaneous endovascular treatment for acute and chronic deep venous thrombosis. J Vasc Surg Venous Lymphat Disord 2013; 1 (01) 52-58
• 19 Spencer EB, Stratil P, Mizones H. Novel treatment techniques for recanalization of femoral-popliteal deep venous occlusion from chronic thrombosis. Tech Vasc Interv Radiol 2014; 17 (02) 114-120
• 20 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 (03) 366-371
• 21 Raju S. Treatment of iliac-caval outflow obstruction. Semin Vasc Surg 2015; 28 (01) 47-53
• 22 Neglén P, Tackett Jr TP, Raju S. Venous stenting across the inguinal ligament. J Vasc Surg 2008; 48 (05) 1255-1261
• 23 Neglén P, Oglesbee M, Olivier J, Raju S. Stenting of chronically obstructed inferior vena cava filters. J Vasc Surg 2011; 54 (01) 153-161