Catheter-directed thrombolysis is performed under imaging guidance by interventional radiologists. This procedure is designed to rapidly break up blood clots, restoring blood flow within the vein and potentially preserving valve function. This may minimize the risk of post-thrombotic syndrome, a late complication of DVT that can lead to chronic leg pain and swelling. The interventional radiologist inserts a catheter typically into the vein behind the knee and threads it into the vein containing the clot, using imaging guidance.
The catheter tip is placed into the clot and a “clot-busting” drug is infused directly to the thrombus (clot). The fresher the clot, the faster it dissolves – usually 24-48 hours. Any narrowing in the vein that may lead to future complications can be identified during the procedure and treated with a balloon angioplasty or stent placement.
In patients in whom this is not appropriate and blood thinners are not medically appropriate, an interventional radiologist can insert a vena cava filter, a small device designed to capture blood clots but allow normal liquid blood to pass.
Acute Deep Vein Thrombosis (DVT)
Am I a good candidate?
This procedure is for patients with acute symptomatic DVT who are ambulatory. Your primary care physician often diagnoses a DVT through a physical exam and the results of a medical imaging exam, such as ultrasound, MRI or CT. Typical signs of a DVT are unexplained redness and painful swelling.
What should I Expect?
The procedure takes between 1-2 hours to complete. This procedure requires hospitalization, often in the Intensive Care Unit (ICU), so the patient can be closely monitored. Hospitalization may last between 1-3 days.
Patients can return to normal activities the day following their release from the hospital.
Consult your primary care physician or hematologist.
This procedure provides early symptomatic relief of acute DVT and prevention of potential long-term complications, including chronic leg pain and swelling.