All Journals from Robert H Mallinson
Abstract
Lower extremity deep vein thrombosis (DVT) is a common disease associated with serious short term and long term complications. Its conventional treatment has been anticoagulation. Thrombolytic treatment has been used for DVT for over 40 years. More recently catheter directed thrombolysis has taken over systemic thrombolysis. This technique is useful to prevent post thrombotic syndrome (PTS) after DVT.
In this review article we present a case of DVT thrombolysis in our hospital, look at the pathophysiology of PTS, the mechanism of thrombolysis and the current status of thrombolysis in DVT.
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In the latest edition of the journal, catheter-directed thrombolysis was reviewed (1), and does appear to be an attractive therapeutic option for treatment of deep venous thrombosis, both in prevention of postthrombotic syndrome and avoidance of anticoagulant therapy. I have one concern about the procedure with regards to the quoted bleeding rates. A systematic review reported high bleeding rates at 31% though major bleeding rates were low (2)