Interventional Radiology Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
J Thromb Haemost. 2015 Jun;13 Suppl 1:S245-51. doi: 10.1111/jth.12940.
Advances in image-guided, catheter-based interventions have shown great potential to improve outcomes in patients with venous thromboembolism. Catheter-directed thrombolysis has been shown in one randomized controlled trial to reduce the risk of post-thrombotic syndrome in patients with acute lower extremity deep vein thrombosis; data from a larger national institute of health trial are expected in early 2017. The use of catheter-directed thrombolysis is also being increasingly considered for patients with submassive or massive pulmonary embolism. Preliminary studies suggest that endovascular stent placement and ablative therapies may be used to reduce symptoms and improve quality of life in severely affected patients with established post-thrombotic syndrome. In this article, we summarize the risks and benefits of endovascular venous thromboembolism therapies as currently understood, highlight clinical situations where their benefit may outweigh risks, and describe ongoing and upcoming pivotal research initiatives with multidisciplinary participation.
在影像引导、基于导管的介入治疗方面的进展表明，它们有可能改善静脉血栓栓塞患者的结局。一项随机对照试验表明，导管直接溶栓治疗可降低急性下肢深静脉血栓形成患者发生血栓后综合征的风险；预计 2017 年初将获得来自更大的国立卫生研究院试验的数据。导管直接溶栓治疗也越来越多地被用于亚大块或大块肺栓塞患者。初步研究表明，血管内支架置入和消融疗法可用于减轻严重的血栓后综合征患者的症状并提高其生活质量。在本文中，我们总结了目前已知的血管内静脉血栓栓塞治疗的风险和获益，强调了其获益可能超过风险的临床情况，并描述了正在进行和即将开展的多学科参与的关键性研究计划。
