Determinants of catheter-directed thrombolysis success

Gameel, Abdelrahman M.; Zedan, Mohamed Hamed; Mohamed Mustafa, Sherif Mamdouh; Elsabbagh, Mahmoud Ahmed

doi:10.21608/zumj.2025.366280.3867

Determinants of catheter-directed thrombolysis success

Document Type : Review Articles

Authors

¹ Professor & Head of vascular surgery, Faculty of Medicine, Zagazig University, Egypt

² Assistant professor of vascular surgery, Faculty of Medicine, Zagazig University, Egypt

³ Department of vascular Surgery, Faculty of Medicine, Zagazig University, Egypt

⁴ Lecturer of vascular surgery, Faculty of Medicine, Zagazig University, Egypt

10.21608/zumj.2025.366280.3867

Abstract

Background: Globally, deep vein thrombosis (DVT) is a serious health issue. Although the risk of pulmonary embolism after DVT is widely known, the long-term vascular consequences of DVT are frequently overlooked, expensive to treat, and can significantly impair quality of life. A minimally invasive endovascular procedure called catheter-directed thrombolysis (or CDT) is performed in conjunction with anticoagulation. By preventing valvular damage and lowering clot burden, CDT reduces the incidence of PTS. Under fluoroscopy, a catheter is inserted straight into the thrombosis site, and a relatively small dosage of thrombolytic drug is then slowly and continuously infused. Acute symptoms are relieved more quickly with CDT because it recovers venous patency more quickly than anticoagulation. Because they provide extra mechanical thrombectomy or ultrasound-enhanced thrombolysis at the moment of catheter placement, adjunctive CDT methods have grown in popularity among interventional radiologists. These pharmacomechanical CDT (PCDT) methods may shorten treatment durations and lower related medical expenses. Conclusion: CDT may reduce the likelihood of PTS and/or lessen the intensity of PTS symptoms if they do occur, however it is most beneficial for patients with extended life expectancy and acute thrombosis affecting the iliac and proximal femoral veins (iliofemoral DVT). Additionally, CDT is crucial for patients with severe DVT symptoms or acute limb-threatening venous blockage.

Keywords