Endovascular Treatment in Patients with Deep Venous Thrombosis

Treatment of deep vein thrombosis (DVT) has changed and evolved with discovery of new drugs and modern invasive methods of diagnosis and treatment. To date, anticoagulation is the generally accepted approach for DVT of the lower extremities. At the same time, endovascular treatment of these patients is interesting. These methods include catheter thrombolysis, endovascular mechanical thromboextraction and their combination. Large-scale randomized clinical trials have shown that such interventions are not advisable in all patients with DVT. Effectiveness and feasibility of these interventions are determined by such criteria as age, DVT extent, severity of symptoms and duration of disease. The most perspective group for endovascular treatment of DVT are patients with iliofemoral thrombosis, as well as patients younger than 65 years and those with severe symptoms (Villalta score > 15). Optimal timing for such interventions is unclear. Early interventions may be more effective considering pathophysiological changes in the thrombus over time. When planning catheter thrombolysis, we should analyze risk-to-benefit ratio, absolute and relative contraindications. Currently, there are devices for endovascular thromboextraction from various veins. Each tool has different properties depending on clinical objective.