Abstract
Thromboembolic disease and its complications can be life threatening. Chronic proximal deep venous thrombosis can lead to the development of post-thrombotic syndrome.
Conservative therapy with anticoagulation is effective in preventing negative outcomes. It does not, however, lead to thrombus dissolution, although it stops its growth.
The recanalisation is therefore spontaneous, resulting from the fibrinolytic ability of human tissues and thrombus remodelling. Percutaneous trans-catheter treatment of DVT patients involves thrombus removal using local thrombolysis, mechanical thrombectomy, angioplasty, and stenting of venous stenosis or obstruction.
Local thrombolytic therapy can be recommended for symptomatic patients with low risk of bleeding. Mechanical recanalisation can cause injury to the vessel wall, valves or be insufficient in thrombus removal.
Although no large, prospective, randomised studies comparing anticoagulation and interventional treatment of proximal DVT have been conducted so far, interventional treatment has its place and can be considered in certain clinical situations.