17/10/2023 17:23:19 |
0 binh luận
SUMMARY Endovascular management of the lower extremity deep vein thrombosis Lê Trọng Bỉnh Lower extremity deep vein thrombosis (LEDVT) is a common vascular disease which may cause life-threatening complications such as pulmonary embolism or lead to lifelong sequelae such as post-thrombotic syndrome. Anticoagulation remains the standard treatment of LEDVT endorsed by various international practice guidelines. However, anticoagulation alone is usually inadequate in the setting of large thrombus burden (iliofemoral DVT), extensive LEDVT (inferior vena cava extension), and venous outflow obstruction (eg, May-Thurner syndrome), therefore increases the risk of delayed symptom alleviation, thrombus recurrence, and disease progression. Prompt diagnosis and timely intervention including effective thrombus exclusion and venous outflow recanalization are crucial in optimizing treatment outcomes, limiting complications, and preventing further sequelae. Recently, endovascular approach has shown advantages over open surgery and medical treatment in selected populations of LEDVT. This minimally invasive technique includes a single-session and step-by-step intervention combining an inferior vena cava filter insertion, catheter-directed thrombolysis, mechanical thrombectomy, and iliocaval recanalization by venoplasty and/or stenting. This paper aims to provide insight into the current status of endovascular treatment of LEDVT and experience from a single center. Keywords: deep vein thrombosis, thrombolysis, thrombectomy, endovascular, May-Thurner syndrome