Siciliano Francesco, Ronconi Edoardo, Rossi Tommaso, Fanelli Federica, Krokidis Miltiadis, Sirignano Pasqualino, Rossi Michele, Tipaldi Marcello Andrea
Department of Surgical and Medical Sciences and Translational Medicine School of Medicine and Psychology, "Sapienza" - University of Rome, Rome, Italy.
Department of Radiology, Sant'Andrea University Hospital La Sapienza, Rome, Italy.
CVIR Endovasc. 2024 Nov 26;7(1):82. doi: 10.1186/s42155-024-00495-x.
AIM OF THE STUDY: This systematic review aims to evaluate the efficacy, safety, and comparative outcomes of endovascular treatments for acute lower limb deep vein thrombosis (DVT), including catheter-directed thrombolysis (CDT), pharmacomechanical thrombectomy (PMT), mechanical thrombectomy, and venous stenting, drawing insights from a diverse range of studies.
A comprehensive literature search identified 33 relevant studies, including randomized controlled trials, cohort studies, systematic reviews, and case reports. Data extraction focused on study design, intervention type, outcome measures, and follow-up duration.
Catheter-directed thrombolysis demonstrates promising results in enhancing venous patency and reducing post-thrombotic syndrome, with careful patient selection being crucial. Pharmacomechanical and mechanical thrombectomy devices offer immediate and long-term benefits, emphasizing individualized patient care. Venous stenting serves as a crucial adjunctive therapy, particularly in cases of residual venous obstruction, though further research is needed for optimal patient selection and long-term outcomes. Timing and selection of endovascular interventions remain critical considerations, necessitating multidisciplinary approaches and ongoing research.
This review provides valuable insights for clinicians and researchers, guiding evidence-based decision-making and shaping future research directions in the dynamic field of endovascular interventions for acute lower limb DVT.
研究目的：本系统评价旨在评估急性下肢深静脉血栓形成（DVT）的血管内治疗的疗效、安全性和比较结果，包括导管定向溶栓（CDT）、药物机械性血栓清除术（PMT）、机械性血栓清除术和静脉支架置入术，从各种研究中获取见解。
全面的文献检索确定了33项相关研究，包括随机对照试验、队列研究、系统评价和病例报告。数据提取集中在研究设计、干预类型、结局指标和随访时间。
导管定向溶栓在提高静脉通畅率和减少血栓形成后综合征方面显示出有前景的结果，谨慎选择患者至关重要。药物机械性和机械性血栓清除装置提供即时和长期益处，强调个体化患者护理。静脉支架置入术是一种关键的辅助治疗，特别是在残留静脉阻塞的情况下，尽管需要进一步研究以优化患者选择和长期结局。血管内干预的时机和选择仍然是关键考虑因素，需要多学科方法和持续研究。
本评价为临床医生和研究人员提供了有价值的见解，指导基于证据的决策制定，并塑造急性下肢DVT血管内干预动态领域的未来研究方向。
