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Semin intervent Radiol
DOI: 10.1055/s-0045-1812095
Review Article

Advances in Thrombolytic Therapies for Venous Thromboembolism: A Review of Contemporary Approaches and Technologies

Authors

  • Kamil Tomaszek

    2   Interventional Radiology, Rush Medical Center, Chicago, Illinois

  • Jonathan Paul

    1   Interventional Radiology, University of Chicago, Chicago, Illinois

  • Osman Ahmed

    1   Interventional Radiology, University of Chicago, Chicago, Illinois
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Abstract

New catheter-based technologies in the treatment of thrombolysis of venous thromboembolism have changed the landscape of the treatment of that disease spectrum. Traditional catheter-directed thrombolysis (CDT) typically involved placement of a lysis catheter and infusion of thrombolytic medications in the ICU setting for many hours, requiring frequent monitoring of fibrinogen, and titration of the thrombolytic agent based on patient-reported symptom improvement and standard vital signs. However, new devices and studies have shown effectiveness with significantly shorter infusion times and medication use, and have introduced features that may help to personalize therapy and help to preserve resources such as ICU bed allocation. This review examines the most recent advances in thrombolysis technology focusing on innovative devices and their clinical implications.

Keywords

interventional radiology - pulmonary embolism - venous thrombosis - lysis - technology - catheter-directed therapy

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Publication History

Article published online:
24 October 2025

© 2025. Thieme. All rights reserved.

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  • References

  • 1 Sterling KM, Goldhaber SZ, Sharp ASP. et al. Prospective multicenter international registry of ultrasound-facilitated catheter-directed thrombolysis in intermediate-high and high-risk pulmonary embolism (KNOCOUT PE). Circ Cardiovasc Interv 2024; 17 (03) e013448
    CrossrefPubMedSearch in Google Scholar
  • 2 Piazza G, Hohlfelder B, Jaff MR. et al; SEATTLE II Investigators. A prospective, single-arm, multicenter trial of ultrasound-facilitated, catheter-directed, low-dose fibrinolysis for acute massive and submassive pulmonary embolism: the SEATTLE II study. JACC Cardiovasc Interv 2015; 8 (10) 1382-1392
    CrossrefPubMedSearch in Google Scholar
  • 3 Bashir R, Foster M, Iskander A. et al. Pharmacomechanical catheter-directed thrombolysis with the Bashir endovascular catheter for acute pulmonary embolism: the RESCUE study. JACC Cardiovasc Interv 2022; 15 (23) 2427-2436
    CrossrefPubMedSearch in Google Scholar
  • 4 Monteleone P, Ahern R, Banerjee S. et al. Modern treatment of pulmonary embolism (USCDT vs MT): results from a real-world, big data analysis (REAL-PE). J Soc Cardiovasc Angiogr Interv 2023; 3 (01) 101192
    PubMedSearch in Google Scholar
  • 5 Rahaghi FN, San José Estépar R, Goldhaber SZ. et al. Quantification and significance of pulmonary vascular volume in predicting response to ultrasound-facilitated, catheter-directed fibrinolysis in acute pulmonary embolism (SEATTLE-3D). Circ Cardiovasc Imaging 2019; 12 (12) e009903
    CrossrefPubMedSearch in Google Scholar