Endovascular Treatment for Lower Extremity Deep Vein Thrombosis

In lower extremity the primary pathway for venous flow is through the deep veins rather than the superficial ones. Consequently, cases involving deep vein thrombosis (DVT) can lead to significant impairments in the venous return of the lower extremities, resulting in symptoms such as swelling, discomfort, and difficulties with gait. The risk factors for DVT can be categorized into two groups: inherited and acquired causes. In a review conducted by authors from Korea, effective endovascular treatment approaches for lower extremity DVT are thoroughly examined and discussed. The initial step in the diagnostic process involves the utilization of various imaging methods, including ultrasonography (US), CT venography, and MR venography. These techniques aid in accurately identifying and assessing the extent of the thrombosis. Endovascular thrombus removal is typically recommended for cases involving massive proximal acute DVT (such as iliofemoral or femoropopliteal thrombosis) accompanied by severe symptomatic leg swelling. The authors highlight several endovascular techniques utilized for thrombus removal and recanalization. These techniques include catheter-directed thrombolysis (CDT), pharmacomechanical thrombectomy (PMT), ultrasound-guided procedures, large-bore catheter aspiration, balloon angioplasty or maceration, and stent placement. Among these techniques, CDT and PMT are recognized as the primary treatment methods for lower extremity DVT. For a detailed description of these techniques, please refer to the original article, where the authors provide comprehensive insights into application and effectiveness.