Klein Seth J, Vedantham Suresh
The Interventional Radiology Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.
Semin Intervent Radiol. 2012 Mar;29(1):23-8. doi: 10.1055/s-0032-1302448.
Practicing interventional radiologists (IRs) are routinely faced with challenging decisions that pertain to the management of patients with acute deep vein thrombosis (DVT). In this article, we describe five questions that are commonly posed by interventionalists and discuss both the indirect published evidence as well as our own experience in dealing with these issues. Our aim is to address procedural and, perhaps more importantly, nonprocedural-related knowledge domains with which the IR physician is less familiar and are often not directly addressed by published data or evidence-based clinical practice guidelines. This discussion is meant to facilitate a stronger understanding of the published literature as it pertains to the justifiable indications for endovascular thrombolytic therapy, the optimal use of anticoagulant therapy, and the reasonable use of adjuncts such as inferior vena cava filters and elastic compression stockings. Our goal is to provide a framework for practicing IRs to help them make the best clinical decisions for their individual patients and, ultimately, achieve optimal DVT treatment outcomes.
从事介入放射学的医生（IRs）经常面临与急性深静脉血栓形成（DVT）患者管理相关的具有挑战性的决策。在本文中，我们描述了介入医生通常会提出的五个问题，并讨论了已发表的间接证据以及我们自己处理这些问题的经验。我们的目的是解决介入放射科医生不太熟悉且已发表的数据或循证临床实践指南通常未直接涉及的程序方面以及或许更重要的非程序相关知识领域。本讨论旨在促进对已发表文献的更深入理解，因为这些文献涉及血管内溶栓治疗的合理适应症、抗凝治疗的最佳使用以及下腔静脉滤器和弹性压迫袜等辅助手段的合理使用。我们的目标是为执业介入放射科医生提供一个框架，以帮助他们为个体患者做出最佳临床决策，并最终实现最佳的DVT治疗效果。
