Challenges in revascularization of the venous circulation: Deep vein thrombosis, venous disorders, and the role of deep venous stenting

Liam Musto, Hayley Moore, Prakash Saha

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

Venous thromboembolism is common and debilitating disease placing huge economic burden on healthcare systems around the world. The mainstay of therapy is anticoagulation, but an evidence base is building for the role of venous interventions such as catheter-directed thrombolysis and deep venous stenting when the supra-inguinal segment is involved and the patient is very symptomatic. Post-thrombotic syndrome is a potential sequela and can complicate up to half of acute DVT cases leading to significant disability and loss of quality of life. A number of large trials have been conducted to compare the role of percutaneous endovenous interventions against anticoagulation in acute DVT, summarized within this chapter. Obstruction to deep venous outflow and non-thrombotic iliac vein lesions such as intraluminal scarring, webs and spurs, can contribute to venous hypertension and the pathophysiology of post-thrombotic syndrome. Deep venous stenting can provide major symptom relief in cases of severe post-thrombotic syndrome and chronic venous obstruction. Strategies for deep venous stenting are discussed within this chapter including the use of imaging modalities such as intravenous ultrasound.

Original languageEnglish
Title of host publicationDebulking in Cardiovascular Interventions and Revascularization Strategies
Subtitle of host publicationBetween a Rock and the Heart
PublisherElsevier
Pages765-774
Number of pages10
ISBN (Electronic)9780128214510
DOIs
Publication statusPublished - 1 Jan 2022

Keywords

  • Catheter directed thrombolysis
  • Deep vein thrombosis
  • Post-thrombotic syndrome
  • Thrombolysis
  • Venous stenting
  • Venous thromboembolism

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