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Semin intervent Radiol 2017; 34(01): 25-34
DOI: 10.1055/s-0036-1597761
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of Cavoatrial Deep Venous Thrombosis: Incorporating New Strategies

Mohamed A. Zayed
1   Section of Vascular Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
2   Department of Surgery, Veterans Affairs St. Louis Health Care System, St. Louis, Missouri
,
Gayan S. De Silva
1   Section of Vascular Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
,
Raja S. Ramaswamy
3   Interventional Radiology Section, Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, Missouri
,
Luis A. Sanchez
1   Section of Vascular Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
› Author Affiliations
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Publication History

Publication Date:
02 March 2017 (online)

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Abstract

Cavoatrial deep venous thrombosis (DVT) is diagnosed with increasing prevalence. It can be managed medically with anticoagulation or with directed interventions aimed to efficiently reduce the thrombus burden within the target venous segment. The type of management chosen depends greatly on the etiology and chronicity of the thrombosis, existing patient comorbidities, and the patient's tolerance to anticoagulants and thrombolytic agents. In addition to traditional percutaneous catheter-based pharmacomechanical thrombolysis, other catheter-based suction thrombectomy techniques have emerged in recent years. Each therapeutic modality requires operator expertise and a coordinated care paradigm to facilitate successful outcomes. Open surgical thrombectomy is alternatively reserved for specific patient conditions, including intolerance of anticoagulation, failed catheter-based interventions, or acute emergencies.

Keywords

deep venous thrombosis - thrombolysis - thrombectomy
 

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