2.2 Iliofemoral vein
Acute thrombosis for iliofemoral veins: thrombolysis or pharmaco-mechanical thrombolysis?
A. Camerota
Acute iliofemoral deep vein thrombosis (DVT) is associated with the most severe postthrombotic morbidity when treated with anticoagulation alone.
According to the author, patients submitted to thrombectomy compared with anticoagulation alone have improved latency, lower venous pressures, less leg swelling, and fewer postthrombotic symptoms. Catheter directed thrombolysis (CDT) has been shown to reduce postthrombotic morbidity, improve quality of life, and reduce recurrent DVT.
The addition of external pneumatic compression devices to the leg being treated with CDT has been shown to accelerate lysis to noncompressed limbs.
In conclusion, both methods improve outcomes compared with anticoagulation alone, pharmacomechanical thrombolysis improves efficacy, speeds lysis, shortens treatment time, and causes no adverse effects on valve function.
