Chapter 8: Surgical/Interventional Treatment of Acute Deep Venous Thrombosis

Original authors: Anthony Comerota, Bo Eklof, Jorge L. Martinez, and Robert B. McLafferty

Abstracted by Michael C. Dalsing

Content:

  • Introduction
  • Why remove acute blood clot? Goals of treatment
  • Ways (method) of removing acute blood clot
  • Venous narrowing (stenosis) may be seen as one cause of the blood clot
  • Risks connected to removing acute blood clot
  • Expected results
  • Conclusion
  • Commonly asked questions
    • What is thrombolysis?
    • Which patients derive the most benefit from catheter-directed thrombolysis?
    • What are the objectives of thrombolysis or surgical thrombectomy?
    • Are there other benefits of catheter-directed thrombolysis or surgical thrombectomy?
    • What are the risks of using thrombolysis to remove free blood clot?
    • Are there alternatives to catheter-directed thrombolysis for extensive venous thrombosis?
    • Why are blood thinner used after thrombolysis or surgical thrombectomy?

Summary:

There are several interventional treatment options for acute deep venous thrombosis (DVT): catheter-directed thrombolysis with or without mechanical device use is the preferred treatment option for patients with iliofemoral deep venous thrombosis who are otherwise healthy and have no contraindication to receiving a thrombolytic drug. If thrombolysis is too high a risk, venous thrombectomy is recommended. For patients who are bedridden and those who are in very poor health, treatment with anticoagulation agents (blood-thinning agents) alone may be advisable. Successful and timely clot removal in patients with iliofemoral DVT results is less post-thrombotic symptoms and an improved health-related qualityof life.

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