J Korean Med Assoc.  2007 Jul;50(7):639-644. 10.5124/jkma.2007.50.7.639.

Interventional Treatment of Venous Thrombosis

• Yoon HK

• KMID: 2184874
• DOI: http://doi.org/10.5124/jkma.2007.50.7.639

Abstract

Thrombosis can develop in any veins from vena cavae to peripheral extremity veins. It can develop from underlying steno-occlusive diseases of the vein such as May-Thurner syndrome, Budd-Chiari syndrome, thoracic outlet syndrome, etc. or with hypercoagulable diathesis due to various causes. When venous thrombosis develops, it can be managed medically or surgically. However, recent advances of endovascular interventional radiological procedures, more cases of venous thrombosis can be dealt with radiological interventions. Catheter-directed thrombolysis is the most commonly-used radiologic intervention for venous thrombosis, which has been proven safe and effective during the past years. Other radiological interventions encompass mechanical thrombectomy, balloon angioplasty and/or stenting, or combinations of each method. Owing to these radiological interventions, more patients can be treated in minimally invasive manners with less procedure-related discomfort, while with higher therapeutic efficacies and more improved safety. Still the standard treatment algorithm has not been accomplished for venous thrombotic diseases, and the best treatment protocol is warranted by cooperation of each expertise in internal medicine, surgery, and interventional radiology.

Keyword

Venous thrombosis; Thrombolysis; Thrombectomy; Endovascular intervention

MeSH Terms

Angioplasty, Balloon
Budd-Chiari Syndrome
Clinical Protocols
Disease Susceptibility
Extremities
Humans
Internal Medicine
May-Thurner Syndrome
Radiology, Interventional
Stents
Thoracic Outlet Syndrome
Thrombectomy
Thrombosis
Veins
Venous Thrombosis*

Figure

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  Figure 1 Aspiratioin thrombectomy. Thrombus can be extracted from the vein by contact wih catheter tip and continuous application of negative pressure.

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  Figure 2 Arrow-Trerotola thrombectomy device. Thrombus can be pulverized by rapid propelling motion of the basket and subsequently extracted through a side-hole of the catheter.

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  Figure 3 Angioplasty for Budd-chiari syndrome. Membranous obstruction of suprahepatic inferior vena cava was treated with double balloon angioplasty resulted in hemodynamic improvement.

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