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Endovascular treatment of lower limb acute DVT: current trends and future directions

  • Francesco Siciliano,
  • Edoardo Ronconi,
  • Tommaso Rossi,
  • Federica Fanelli,
  • Miltiadis Krokidis,
  • Pasqualino Sirignano,
  • Michele Rossi,
  • Marcello Andrea Tipaldi

摘要

Aim of the study

This systematic review aims to evaluate the efficacy, safety, and comparative outcomes of endovascular treatments for acute lower limb deep vein thrombosis (DVT), including catheter-directed thrombolysis (CDT), pharmacomechanical thrombectomy (PMT), mechanical thrombectomy, and venous stenting, drawing insights from a diverse range of studies.

Materials and methods

A comprehensive literature search identified 33 relevant studies, including randomized controlled trials, cohort studies, systematic reviews, and case reports. Data extraction focused on study design, intervention type, outcome measures, and follow-up duration.

Results

Catheter-directed thrombolysis demonstrates promising results in enhancing venous patency and reducing post-thrombotic syndrome, with careful patient selection being crucial. Pharmacomechanical and mechanical thrombectomy devices offer immediate and long-term benefits, emphasizing individualized patient care. Venous stenting serves as a crucial adjunctive therapy, particularly in cases of residual venous obstruction, though further research is needed for optimal patient selection and long-term outcomes. Timing and selection of endovascular interventions remain critical considerations, necessitating multidisciplinary approaches and ongoing research.

Conclusion

This review provides valuable insights for clinicians and researchers, guiding evidence-based decision-making and shaping future research directions in the dynamic field of endovascular interventions for acute lower limb DVT.