Endovascular intervention in acute deep vein thrombosis

The widespread prevalence of deep venous thrombosis (DVT) is well documented. Its acute and chronic manifestations, including the post-thrombotic syndrome (PTS), inflict a heavy personal and socioeconomic burden on society. Conventional anticoagulation treatment regimens have been widely used in the treatment of acute DVT, with many patients developing significant long-term morbidity. Numerous systemic, surgical, and endovascular therapies have been employed in an attempt to achieve immediate and effective clot lysis. In this paper, we discuss these various techniques, their efficacy as established in the current literature, and their risks and benefits. Pharmacomechanical thrombolysis (PMT) specifically has recently emerged as a low-risk, highly effective means of treating acute DVT, often being performed in the outpatient setting. Ongoing investigations will help further define the utility of this evolving transformative therapy.