Deep vein thrombosis (DVT) is a common disease; however, it can result in significant disabilities from pulmonary embolism and postphlebitic syndrome, especially when the iliofemoral vein is involved. Although anticoagulation can prevent thrombus propagation and recurrent venous thrombosis, it cannot dissolve the occluding thrombus or reduce venous outflow obstruction, leaving the patients suffering from postphlebitic syndrome. Catheter-directed thrombolysis, with direct delivery of a concentrated lytic agent into the clot, has been proposed as an alternative therapy to anticoagulation. Recent studies have demonstrated that early clot lysis through this technique rapidly restores venous patency, more effectively preserves valvular function, and reduces a risk of postphlebitic syndrome. To decrease clot burden, duration of treatment, and bleeding complications, mechanical thrombectomy may work synergistically with catheter-directed thrombolysis. After clot removal through those therapies, balloon angioplasty and stent placement are needed in patients with venous stricture (eg, iliac vein compression syndrome). Short- and long-term outcomes of stenting in iliofemoral DVT appear to be favorable. When used in conjunction with each other and anticoagulation, these minimally invasive endovascular techniques allow a better resolution of venous clot burden and have the potential to lead to improved long-term outcomes in patients with DVT. This review introduces endovascular treatments of acute DVT in the lower extremities performed in the interventional radiology section.
Angioplasty, Balloon ; Constriction, Pathologic ; Endovascular Procedures ; Hemorrhage ; Humans ; Iliac Vein ; Lower Extremity* ; Postphlebitic Syndrome ; Pulmonary Embolism ; Radiology, Interventional ; Stents ; Thrombectomy ; Thrombosis ; Veins ; Venous Thrombosis*