Update on early thrombus removal for iliofemoral deep vein thrombosis

Abstract

Thrombus removal has for many years been attractive to investigate. The reasons were to relieve the acute symptoms with painful swelling and even to avoid tissue loss, but also with focus to decrease the incidence of late complications. Surgical procedures in the beginning and systemic thrombolysis years later were practiced in few dedicated centers. The breakthrough came 30 years ago in order to concentrate the lysis procedure directly into the thrombus material. This minimal invasive catheter-directed procedure was soon combined with stenting of the well-known iliac vein compression syndrome. Further development of this modality has taken place with some adjunctive mechanical devices primarily to minimize bleeding, which is the major concern of the methods. Less than ten RCT’s have been published over time, but conclusively supporting the rationale of early thrombus removal for iliofemoral DVT with reduction of PTS.