Treatment of Symptomatic Lower Extremity Acute Deep Venous Thrombosis: Role of Mechanical Thrombectomy

Abstract

Systemic anticoagulation with heparin or its unfractionated derivatives followed by warfarin therapy has been the mainstay of treatment in patients with lower extremity deep venous thrombosis (DVT). Although heparin is an effective treatment modality in preventing thrombus propagation, it provides minimal therapeutic effect in dissolving preexisting venous thrombus. The clinical consequence of DVT, owing in part to loss of venous endothelial and valvular function, is postphlebitic syndrome or chronic venous insufficiency. Current advances in endovascular therapy have resulted in various endovascular thrombectomy systems that can effectively remove a large venous thrombus burden, which may represent a potential advantage of preserving venous valvular function and thereby reduce the likelihood of postphlebitic syndrome. In this article, we review a variety of surgical and interventional methods in venous thrombus removal. Current treatment modalities using mechanical thrombectomy devices and pharmacomechancial thrombectomy strategy are also discussed.

Evaluation of ultrasonic intravascular thrombectomy system on a rabbit model in the treatment of deep vein thrombosis

“…Each of the methods used to prevent postphlebitic syndrome has a great advantage. All significantly reduce the development of postphlebitic syndrome as a result of vein recanalization [10][11][12]. These methods help not only to prevent changes in the chronic phase but also to eliminate complaints in the acute phase, reduce thrombus burden and shorten lysis time [13][14][15].…”

Pulmonary embolism and stroke associated with mechanical thrombectomy

“…8,9 Venous hydration is essential, with the objective of avoiding kidney damage. Our patient did not suffer from significant hemolysis.…”