Venous Interventions

Abstract

These studies indicate that CDT for DVT achieves more rapid lysis, reduces the incidence of long-term sequelae of DVT, improves quality of life, preserves valvular competence and more completely restores vessel patency as compared with standard anticoagulation or systemic thrombolytic therapy, although at the expense of a higher rate of hemorrhagic complications (see Table 1 summary of CDT trials).

Autologous sapheno-saphenous bypass collateral development in the setting of chronic unilateral iliac vein occlusion

“…In this situation it serves as a confirmatory indicator of the presence of an occlusion to in-line venous drainage. Whereas lumbar and cross-pelvic internal iliac drainage pathways are well known (Ahmed and Hagspiel 2001; Butros et al 2013; Englund 2017; Hartung et al 2009; O’Dea and Schainfeld 2014; Neglen and Raju 2002; Neglén and Raju 2000), to our knowledge, there are no reports of autologous development of a sapheno-saphenous collateral bypass pathway secondary to the venous obstruction.…”

Successful Catheter-Directed Thrombolysis of Massive Bilateral Upper Extremity DVT Presenting as Superior Vena Cava Syndrome

“…Reported success rates of traditional long-term anticoagulation and venoplasty are at 84% and 75% to 100%, respectively ( 6 ). Regarding transluminal venoplasty, SVC stenting for malignant disease is cited to have a success rate of 95% to 100% with “primary and secondary patency rates of 85% and 93%, respectively, at 3 months” ( 7 ). Although distal embolization is a known complication of peripheral arterial intervention, we have been unable to find substantial literature discussing concerns of distal embolization in the setting of venous interventions.…”

“…( 3 ). Furthermore, O’Dea and Schainfeld ( 7 ) report that “obstruction at the confluence of the brachial cephalic veins with the SVC poses a special problem for the interventionalist.” Systemic thrombolysis with tPA can cause major bleeding events and stent deployment can cause infection, pulmonary embolism, and SVC perforation. In some cases, stents may migrate after deployment ( 4 ).…”