TY - JOUR
T1 - Pathogenesis of Thromboembolism and Endovascular Management
AU - Behravesh, Sasan
AU - Hoang, Peter
AU - Nanda, Alisha
AU - Wallace, Alex
AU - Sheth, Rahul A.
AU - Deipolyi, Amy R.
AU - Memic, Adnan
AU - Naidu, Sailendra
AU - Oklu, Rahmi
N1 - Publisher Copyright:
© 2017 Sasan Behravesh et al.
PY - 2017
Y1 - 2017
N2 - Venous thromboembolism (VTE), a disease that includes deep venous thrombosis (DVT) and pulmonary embolism (PE), is associated with high mortality, morbidity, and costs. It can result in long-term complications that include postthrombotic syndrome (PTS) adding to its morbidity. VTE affects 1/1000 patients, costs $13.5 billion annually to treat, and claims 100,000 lives annually in the US. The current standard of care for VTE is anticoagulation, though thrombolysis may be performed in patients with PE and threatened limb. This review discusses pathogenesis and medical treatment of VTE and then focuses on endovascular treatment modalities. Mechanical- and catheter-directed thrombolysis (CDT) is discussed, as well as patient selection criteria, and complications. The first prospective study (CaVenT) comparing CDT with anticoagulation alone in acute DVT, despite study shortcomings, corroborates the existing literature indicating improved outcomes with CDT. The potential of the ongoing prospective, multicenter, randomized ATTRACT trial is also highlighted.
AB - Venous thromboembolism (VTE), a disease that includes deep venous thrombosis (DVT) and pulmonary embolism (PE), is associated with high mortality, morbidity, and costs. It can result in long-term complications that include postthrombotic syndrome (PTS) adding to its morbidity. VTE affects 1/1000 patients, costs $13.5 billion annually to treat, and claims 100,000 lives annually in the US. The current standard of care for VTE is anticoagulation, though thrombolysis may be performed in patients with PE and threatened limb. This review discusses pathogenesis and medical treatment of VTE and then focuses on endovascular treatment modalities. Mechanical- and catheter-directed thrombolysis (CDT) is discussed, as well as patient selection criteria, and complications. The first prospective study (CaVenT) comparing CDT with anticoagulation alone in acute DVT, despite study shortcomings, corroborates the existing literature indicating improved outcomes with CDT. The potential of the ongoing prospective, multicenter, randomized ATTRACT trial is also highlighted.
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U2 - 10.1155/2017/3039713
DO - 10.1155/2017/3039713
M3 - Review article
C2 - 28154761
AN - SCOPUS:85038625950
SN - 2090-1488
VL - 2017
JO - Thrombosis
JF - Thrombosis
M1 - 3039713
ER -