Why is percutaneous transcatheter treatment indicated for subacute and chronic iliofemoral DVT?

Updated: Dec 10, 2019
  • Author: Donald Schreiber, MD, CM; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

Subacute and chronic iliofemoral DVT is accompanied by moderate to severe pelvic or limb symptoms with a low bleeding risk. Because recanalization of the iliac vein is unlikely, iliofemoral DVT often produces valvular reflux.

This combination of outflow obstruction and reflux is associated with the most symptomatic forms of PTS. In this situation, patients have venous damage, and the alternative is venous bypass. In these instances, catheter-directed thrombolysis is seldom expected to completely clear the vein, but it is often used to remove any acute component of thrombus and to uncover chronic stenoses or underlying anatomic abnormality as an adjunct to angioplasty or stent placement. Compared with systemic thrombolysis, catheter-directed thrombolysis improves the preservation of valve competence (44% vs 13%).


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