Local thrombolysis for deep vein thrombosis: why, for whom and how?

Czech version

Authors: Martin Radvan ¹; Jakub Hustý ¹; Alena Floriánová ²; Kateřina Hořáková ²; Petr Kala ¹
Authors‘ workplace: Interní kardiologická klinika FN Brno a LF MU, Brno ¹; Klinika radiologie a nukleární medicíny FN Brno a LF MU, Brno ²
Published in: Vnitř Lék 2020; 66(3): 146-151
Category: Main Topic

Overview

Despite the progress achieved in prevention and therapy in recent decades, venous thromboembolic disorder still presents medical burden. Incidence is estimated about 100-200/100 000 per year. Patients, who underwent deep vein thrombosis are at risk of recurrence and/or development of post-thrombotic syndrome. Both can affect the quality of life. In acute phase of the disease anticoagulation and compression are effective therapy in most cases. But in severe clinical manifestations escalation of the therapy should be considered. Surgical embolectomy is possible, but complication rate is high. Endovascular approaches are viable option. Catheter directed local thrombolysis is effective not only in situation of limb emergency (phlegmasia). We summarize indications, technical approach and evidence for this specific treatment.

Keywords:

endovascular therapy – Deep vein thrombosis – local thrombolysis – thrombembolic disease – anticoagulation – posttrombotic syndrome – cava filter

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