A Brief Review of Thrombolytics for Venous Interventions

Sukhdeep K. Grewal, Amanda L. Hedrick, Louise Man, Aditya M. Sharma, Kush R. Desai, Minhaj S. Khaja*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Anticoagulation continues to be the mainstay of therapy for the management of venous thromboembolism. However, anticoagulation does not lead to the breakdown or dissolving of the thrombus. In an acute pulmonary embolism, extensive thrombus burden can be associated with a high risk for early decompensation, and in acute deep venous thrombosis, it can be associated with an increased risk for phlegmasia. In addition, residual thrombosis can be associated with chronic thromboembolic pulmonary hypertension and postthrombotic syndrome in a chronic setting. Thrombolytic therapy is a crucial therapeutic choice in treating venous thromboembolism for thrombus resolution. Historically, it was administered systemically and was associated with high bleeding rates, particularly major bleeding, including intracranial bleeding. In the last two decades, there has been a significant increase in catheter-based therapies with and without ultrasound, where lower doses of thrombolytic agents are utilized, potentially reducing the risk for major bleeding events and improving the odds of reducing the thrombus burden. In this article, we provide an overview of several thrombolytic therapies, including delivery methods, doses, and outcomes.

Original languageEnglish (US)
Pages (from-to)394-399
Number of pages6
JournalSeminars in Interventional Radiology
Volume39
Issue number4
DOIs
StatePublished - Aug 2022

Keywords

  • alteplase
  • interventional radiology
  • thrombolysis
  • venous thromboembolic disease
  • venous thromboembolism

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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