Why is percutaneous transcatheter treatment indicated for acute iliofemoral or femoropopliteal 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

Whether catheter-directed thrombolysis is indicated in the relatively common event of acute iliofemoral or femoropopliteal DVT is somewhat controversial. Catheter-directed thrombolysis may be superior to anticoagulation with regard to decreasing the incidence of recurrent DVT and PTS. However, the evidence is not conclusive.

Catheter-directed thrombolysis improves thrombus clearance compared with systemic thrombolysis. Few DVT cases resolve after heparin therapy, but systemic thrombolysis improves the rate to 30%, and catheter-directed thrombolysis removes 80% of thrombi. [12] Reports of catheter-directed thrombolysis for the management of acute DVT between 1994 and 2004 described anatomic and clinical success rates of 76-100%. The incidence of major hemorrhagic complications was 0-24%.


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