title: The role of thrombolysis in the clinical management of deep vein thrombosis.
abstract: The cornerstones of current management of deep vein thrombosis (DVT) are the routine use of anticoagulant therapy, graduated elastic compression stockings, and early ambulation. Thrombolytic therapy was previously reserved only for patients with life-, limb-, or organ-threatening complications. However, the postthrombotic syndrome has been increasingly recognized as a frequent and serious long-term complication of DVT. In parallel, endovascular thrombolytic methods have evolved considerably in recent years, prompting discussion and controversy as to whether they should be more liberally used. In some centers, pharmacomechanical catheter-directed thrombolysis is now routinely used in the treatment of acute iliofemoral DVT. Randomized trials are currently under way to determine when the use of pharmacomechanical catheter-directed thrombolysis is appropriate in patients presenting with acute proximal DVT.
authors.affiliation: Interventional Radiology Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Radha Krishna
authors.initials: RK
authors.lastname: Popuri
authors.forename: Suresh
authors.initials: S
authors.lastname: Vedantham
mesh_terms: D000208:Acute Disease; D001777:Blood Coagulation / Q000187:drug effects*; D057510:Endovascular Procedures / Q000009:adverse effects; D019317:Evidence-Based Medicine; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D018579:Patient Selection; D054070:Postthrombotic Syndrome / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D015912:Thrombolytic Therapy / Q000009:adverse effects; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000097:blood / Q000150:complications / Q000188:drug therapy*
chemical_list: D005343:Fibrinolytic Agents