4.5 Review

Invasive and Pharmacological Treatment of Deep Vein Thrombosis: A Scoping Review

Journal

CURRENT PHARMACEUTICAL DESIGN
Volume 28, Issue 10, Pages 778-786

Publisher

BENTHAM SCIENCE PUBL LTD
DOI: 10.2174/1381612828666220418084339

Keywords

Deep vein thrombosis; DVT; Venous thromboembolism; pharmacological treatment; thrombolysis; Invasive treatment; Endovascular treatment; catheter-directed thrombolysis

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VTE is a common disease with a high annual incidence in the United States and Europe. The primary treatment for DVT is oral anticoagulation, but more invasive treatments can be used for severe symptoms. However, there is limited knowledge about the outcomes of invasive treatment for VTE.
The annual occurrence of venous thromboembolism (VTE) is 300,000-600,000 cases in the United States and 700,000 in Europe. VTE includes deep venous thrombosis (DVT) of upper or lower extremities, superior and inferior vena cava thrombosis, and pulmonary embolism (PE) as well. The primary treatment of DVT includes oral anticoagulation to prevent the progression of the thrombus and decrease the risk of pulmonary embolism. Depending on the symptoms, more invasive treatments can be applied to target the iliofemoral thrombus and its removal. However, less emphasis is given to acute symptomatology, early recovery of function, quality of life improvement, and the individualized likelihood of developing post-thrombotic syndrome. While invasive therapy has been used to enhance the acute management of iliofemoral DVT, our knowledge about the overall outcomes associated with the invasive treatment of VTE is still limited. In this review, we illustrate the available data on pharmacological and endovascular management of iliofemoral VTE, including therapies such as catheter-directed thrombolysis (CDT), mechanical thrombectomy (PMT), and pharmacome-chanical catheter-directed thrombolysis (PCDT).

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