Endovascular treatment of lower limb acute DVT: current trends and future directions.

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS CVIR Endovascular Pub Date : 2024-11-26 DOI:10.1186/s42155-024-00495-x
Francesco Siciliano, Edoardo Ronconi, Tommaso Rossi, Federica Fanelli, Miltiadis Krokidis, Pasqualino Sirignano, Michele Rossi, Marcello Andrea Tipaldi
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Abstract

AIM OF THE STUDY: This systematic review aims to evaluate the efficacy, safety, and comparative outcomes of endovascular treatments for acute lower limb deep vein thrombosis (DVT), including catheter-directed thrombolysis (CDT), pharmacomechanical thrombectomy (PMT), mechanical thrombectomy, and venous stenting, drawing insights from a diverse range of studies.

Materials and methods: A comprehensive literature search identified 33 relevant studies, including randomized controlled trials, cohort studies, systematic reviews, and case reports. Data extraction focused on study design, intervention type, outcome measures, and follow-up duration.

Results: Catheter-directed thrombolysis demonstrates promising results in enhancing venous patency and reducing post-thrombotic syndrome, with careful patient selection being crucial. Pharmacomechanical and mechanical thrombectomy devices offer immediate and long-term benefits, emphasizing individualized patient care. Venous stenting serves as a crucial adjunctive therapy, particularly in cases of residual venous obstruction, though further research is needed for optimal patient selection and long-term outcomes. Timing and selection of endovascular interventions remain critical considerations, necessitating multidisciplinary approaches and ongoing research.

Conclusion: This review provides valuable insights for clinicians and researchers, guiding evidence-based decision-making and shaping future research directions in the dynamic field of endovascular interventions for acute lower limb DVT.

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下肢急性深静脉血栓的血管内治疗:当前趋势和未来方向。
研究目的:本系统综述旨在评估急性下肢深静脉血栓(DVT)血管内治疗的有效性、安全性和比较结果,包括导管引导溶栓(CDT)、药物机械血栓切除术(PMT)、机械血栓切除术和静脉支架置入术,从各种研究中汲取启示:通过全面的文献检索确定了 33 项相关研究,包括随机对照试验、队列研究、系统综述和病例报告。数据提取的重点是研究设计、干预类型、结果测量和随访时间:结果:导管引导溶栓在提高静脉通畅性和减少血栓后综合征方面取得了可喜的成果,但谨慎选择患者至关重要。药物机械和机械血栓清除装置可提供直接和长期的益处,强调对患者的个体化护理。静脉支架植入术是一种重要的辅助疗法,尤其适用于残余静脉阻塞的病例,但如何选择最佳患者和取得长期疗效仍需进一步研究。血管内介入治疗的时机和选择仍是关键因素,需要多学科方法和持续研究:本综述为临床医生和研究人员提供了有价值的见解,为基于证据的决策提供了指导,并为急性下肢深静脉血栓的血管内介入这一充满活力的领域确定了未来的研究方向。
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来源期刊
CVIR Endovascular
CVIR Endovascular Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
2.30
自引率
0.00%
发文量
59
期刊最新文献
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