The Importance of Early Thrombus Removal

Historically, anticoagulation has been the primary treatment for acute lower extremity deep venous thrombosis (DVT) with or without thrombolysis. Despite large amounts of clinical research data supporting an ‘open vein hypothesis’, which favours early thrombus removal, clinicians have hesitant to take this option due a historically high risk major bleeding and few notable studies that failed show any meaningful benefit. The ATTRACT trial benefit using pharmacomechanical catheter-directed thrombolysis (PCDT) iliofemoral femoropopliteal DVT but did result in more bleeding. However, CaVent study before it revealed significant reduction post-thrombotic syndrome (PTS) patients femoral after long-term follow-up past 24 months grew over time. Since these trials, there advancements magnetic resonance CT venography, intravascular ultrasound (IVUS), stenting thrombectomy catheters meaning is little no need adjunct thrombolytics. Results from ongoing such as CLEAR-DVT reflect advances modern technology.