Abstract
Lower extremity deep vein thrombosis (DVT) is frequently encountered in clinical practice.
Postthrombotic syndrome (PTS) is a common sequela of DVT and encompasses a wide variety
of symptoms, including severe pain, edema, and ulceration, all of which may contribute
to a negative impact on quality of life. Studies have demonstrated that acute thrombosis
of the iliofemoral venous segment is correlated with high rates of PTS, increased
severity of symptoms, and high rates of thrombus recurrence, despite patients receiving
treatment with standard-of-care anticoagulation therapy. Endovascular interventions,
including catheter-directed thrombolysis, pharmacomechanical thrombectomy, and mechanical
thrombectomy, have generated significant interest as a method for reduction of short-term
symptom severity and potential reduction of downstream PTS severity. While there is
high-quality evidence evaluating the role of catheter-directed and pharmacomechanical
thrombectomy for acute iliofemoral DVT, newer mechanical-only devices that utilize
thrombectomy without fibrinolytic medication are less studied. Currently, there are
limited data evaluating the efficacy and safety of these treatment modalities, although
investigations are ongoing.
Keywords
deep venous thrombosis - iliofemoral venous thrombosis - chronic venous insufficiency
- postthrombotic syndrome - catheter-directed thrombolysis
