Abstract This study aims to review current practices in thrombolysis and thrombectomy for managing deep venous thrombosis (DVT) and associated complications in the pediatric population. Pediatric thrombosis care has a rich history of evolution, from the early days of anticoagulation to the current era of endovascular therapies. This evolution has been driven by the need for a nuanced, multidisciplinary approach that includes interventional radiology (IR) and hematology. While anticoagulation remains the standard of care, endovascular therapies are increasingly utilized in cases of extensive, occlusive, or limb-threatening DVT, particularly to prevent pulmonary embolism and postthrombotic syndrome (PTS) and to preserve venous patency. This review outlines the indications, contraindications, and procedural techniques for catheter-directed thrombolysis, pharmaco-mechanical thrombectomy (PMT), mechanical thrombectomy, and venous stenting in children. It emphasizes the crucial role of a multidisciplinary team, including pediatric hematologists, interventional radiologists, and other medical professionals, in managing pediatric DVT. This collaboration is essential for considering pediatric-specific factors such as patient size, sedation requirements, radiation, contrast dosing, and anticoagulation. Also highlighted are postprocedural care, anticoagulation strategies, and imaging follow-up. Multidisciplinary collaboration is critical to improving outcomes for children with thrombotic disease.
Zavaletta et al. (2025) studied this question.