title: Interventional treatment of venous thromboembolism: a review.
abstract: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most common cardiovascular disease after coronary artery disease and cerebrovascular disease and is responsible for significant morbidity and mortality in the general population. Full dose anticoagulation is the standard therapy for VTE, both for the acute and the long-term phase. The latest guidelines of the American College of Chest Physicians recommend treatment with a full-dose of unfractioned heparin (UFH), low-molecular-weight-heparin (LMWH), fondaparinux, vitamin K antagonist (VKA) or thrombolysis for most patients with objectively confirmed VTE. Catheter-guided thrombolysis and trombosuction are interventional approaches that should be used only in selected populations; interruption of the inferior vena cava (IVC) with a filter can be performed to prevent life-threatening PE in patients with VTE and contraindications to anticoagulant treatment, bleeding complications during antithrombotic treatment, or VTE recurrences despite optimal anticoagulation. In this review we summarize the currently available literature regarding interventional approaches for VTE treatment (vena cava filters, catheter-guided thrombolysis, thrombosuction) and we discuss current evidences on their efficacy and safety. Moreover, the appropriate indications for their use in daily clinical practice are reviewed.
authors: Department of Internal Medicine, Piacenza Hospital, Italy. d.imberti@ausl.pc.it
authors: Davide
authors: D
authors: Imberti
authors: Walter
authors: W
authors: Ageno
authors: Roberto
authors: R
authors: Manfredini
authors: Fabio
authors: F
authors: Fabbian
authors: Raffaella
authors: R
authors: Salmi
authors: Rita
authors: R
authors: Duce
authors: Massimo
authors: M
authors: Gallerani
mesh_terms: D057505:Embolic Protection Devices; D019317:Evidence-Based Medicine; D006801:Humans; D061185:Mechanical Thrombolysis / Q000295:instrumentation* / Q000379:methods*; D013396:Suction / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome; D054556:Venous Thromboembolism