Pathogenesis of Thromboembolism and Endovascular Management

Sasan Behravesh, Peter Hoang, Alisha Nanda, Alex Wallace, Rahul A. Sheth, Amy R. Deipolyi, Adnan Memic, Sailendra Naidu, Rahmi Oklu

Research output: Contribution to journalReview articlepeer-review

20 Scopus citations

Abstract

Venous thromboembolism (VTE), a disease that includes deep venous thrombosis (DVT) and pulmonary embolism (PE), is associated with high mortality, morbidity, and costs. It can result in long-term complications that include postthrombotic syndrome (PTS) adding to its morbidity. VTE affects 1/1000 patients, costs $13.5 billion annually to treat, and claims 100,000 lives annually in the US. The current standard of care for VTE is anticoagulation, though thrombolysis may be performed in patients with PE and threatened limb. This review discusses pathogenesis and medical treatment of VTE and then focuses on endovascular treatment modalities. Mechanical- and catheter-directed thrombolysis (CDT) is discussed, as well as patient selection criteria, and complications. The first prospective study (CaVenT) comparing CDT with anticoagulation alone in acute DVT, despite study shortcomings, corroborates the existing literature indicating improved outcomes with CDT. The potential of the ongoing prospective, multicenter, randomized ATTRACT trial is also highlighted.

Original languageEnglish (US)
Article number3039713
JournalThrombosis
Volume2017
DOIs
StatePublished - 2017

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine

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