[Pro and contra: aggressive or conservative thrombosis therapy? - Pro aggressive thrombosis therapy]. 2014

J Grommes
Europäisches Gefäßzentrum Aachen-Maastricht, RWTH Aachen Universitätsklinik, Aachen, Deutschland.

The post-thrombotic syndrome (PTS), long-term sequelae of a deep vein thrombosis (DVT), reduces quality of life and is of great socio-economic importance. Despite conservative treatment which does not directly facilitate recanalization more than 25% of patients develop PTS. Early thrombus removal may decrease the incidence and severity of PTS. Although the evidence for surgical thrombectomy is weak which allows an early and rapid recanalization, this therapy appears to reduce the risk of PTS and iliofemoral thrombosis. Systemic thrombolysis can reduce the incidence of PTS but it is no longer recommended due to serious bleeding complications. Previous studies with new endovascular catheter-guided procedures allowing local application of thrombolysis and thrombus aspiration displayed promising results. However, so far one prospective randomised study (CaVent study) with long-term results has revealed a significant reduction of PTS. The current evidence recommends early thrombus removal for patients at high risk for PTS. New endovascular procedures such as catheter-guided thrombolysis allow rapid thrombus removal but more prospective randomised studies are necessary to ensure the long-term success of this therapy.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000925 Anticoagulants Agents that prevent BLOOD CLOTTING. Anticoagulant Agent,Anticoagulant Drug,Anticoagulant,Anticoagulant Agents,Anticoagulant Drugs,Anticoagulation Agents,Indirect Thrombin Inhibitors,Agent, Anticoagulant,Agents, Anticoagulant,Agents, Anticoagulation,Drug, Anticoagulant,Drugs, Anticoagulant,Inhibitors, Indirect Thrombin,Thrombin Inhibitors, Indirect
D015912 Thrombolytic Therapy Use of infusions of FIBRINOLYTIC AGENTS to destroy or dissolve thrombi in blood vessels or bypass grafts. Fibrinolytic Therapy,Thrombolysis, Therapeutic,Therapeutic Thrombolysis,Therapy, Fibrinolytic,Therapy, Thrombolytic,Fibrinolytic Therapies,Therapeutic Thrombolyses,Therapies, Fibrinolytic,Therapies, Thrombolytic,Thrombolyses, Therapeutic,Thrombolytic Therapies
D017131 Thrombectomy Surgical removal of an obstructing clot or foreign material from a blood vessel at the point of its formation. Removal of a clot arising from a distant site is called EMBOLECTOMY. Aspiration Thrombectomy,Percutaneous Aspiration Thrombectomy,Aspiration Thrombectomies,Aspiration Thrombectomies, Percutaneous,Aspiration Thrombectomy, Percutaneous,Percutaneous Aspiration Thrombectomies,Thrombectomies,Thrombectomies, Aspiration,Thrombectomies, Percutaneous Aspiration,Thrombectomy, Aspiration,Thrombectomy, Percutaneous Aspiration
D054070 Postthrombotic Syndrome A condition caused by one or more episodes of DEEP VEIN THROMBOSIS, usually the blood clots are lodged in the legs. Clinical features include EDEMA; PAIN; aching; heaviness; and MUSCLE CRAMP in the leg. When severe leg swelling leads to skin breakdown, it is called venous STASIS ULCER. Venous Stasis Syndrome,Syndrome, Postthrombotic,Syndrome, Venous Stasis
D057510 Endovascular Procedures Minimally invasive procedures, diagnostic or therapeutic, performed within the BLOOD VESSELS. They may be perfomed via ANGIOSCOPY; INTERVENTIONAL MAGNETIC RESONANCE IMAGING; INTERVENTIONAL RADIOGRAPHY; or INTERVENTIONAL ULTRASONOGRAPHY. Endovascular Techniques,Intravascular Procedures,Intravascular Techniques,Endovascular Procedure,Endovascular Technique,Intravascular Procedure,Intravascular Technique,Procedure, Endovascular,Procedure, Intravascular,Procedures, Endovascular,Procedures, Intravascular,Technique, Endovascular,Technique, Intravascular,Techniques, Endovascular,Techniques, Intravascular
D061345 Early Medical Intervention Action taken to reduce susceptibility or exposure to health problems and to detect and treat disease in early stages. Early Medical Interventions,Intervention, Early Medical,Interventions, Early Medical,Medical Intervention, Early,Medical Interventions, Early
D020246 Venous Thrombosis The formation or presence of a blood clot (THROMBUS) within a vein. Deep Vein Thrombosis,Phlebothrombosis,Thrombosis, Deep Vein,Thrombosis, Venous,Deep Venous Thrombosis,Deep-Vein Thrombosis,Deep-Venous Thrombosis,Deep Vein Thromboses,Deep Venous Thromboses,Deep-Vein Thromboses,Deep-Venous Thromboses,Phlebothromboses,Thromboses, Deep Vein,Thromboses, Deep Venous,Thromboses, Deep-Vein,Thromboses, Deep-Venous,Thromboses, Venous,Thrombosis, Deep Venous,Thrombosis, Deep-Vein,Thrombosis, Deep-Venous,Vein Thromboses, Deep,Vein Thrombosis, Deep,Venous Thromboses,Venous Thromboses, Deep,Venous Thrombosis, Deep

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