Thrombolytic Therapy for Lower Extremity Deep Vein Thrombosis and the North American Venous Registry

Abstract

The ideal goals of therapy for acute deep vein thrombosis (DVT) is the elimination of the embolic potential of existing thrombus, restoration of unobstructed flow, prevention of further thrombosis, and preservation of venous valve function. Meeting these goals will not only prevent pulmonary embolism (PE) but will also minimize the long-term sequelae of venous hypertension and the development of the post-thrombotic syndrome (PTS). Treatment strategies aimed at eliminating or reducing the risk of PTS should focus on preserving valvular function and eliminating the risk of continued venous obstruction following acute DVT. Thrombolytic drugs are an attractive form of early therapy because they have the ability to eliminate obstructive thrombus in the deep veins and should therefore help provide protection against PTS. The perceived benefits of early and rapid recanalization in preserving valve function have been the basis for the use of thrombolytic therapy to treat acute DVT.