Interventional Therapies

Catheter-Directed Thrombolysis:

• Mechanism: Administering thrombolytic agents directly into the clot to accelerate its dissolution.
• Indications: Severe symptoms, extensive clot burden, high risk of post-thrombotic syndrome.
• Contraindications: High bleeding risk, recent surgery, active bleeding.
• Clinical Pearls: Careful patient selection is crucial; bleeding risk assessment is essential.

Thrombectomy:

• Mechanism: Mechanical removal of thrombus using devices such as catheters, stents, or aspiration systems.
• Indications: Acute limb-threatening ischemia, massive iliofemoral DVT, failed anticoagulation.
• Contraindications: High bleeding risk, recent surgery, large thrombus burden.
• Clinical Pearls: Timely intervention is critical in cases of acute limb ischemia.

Filters:

• Mechanism: Placed in the inferior vena cava (IVC) to trap emboli and prevent pulmonary embolism.
• Indications: Contraindication or failure of anticoagulation, high bleeding risk.
• Contraindications: IVC anomalies, extensive DVT, chronic venous insufficiency.
• Clinical Pearls: Considered when anticoagulation is not feasible or effective.