Contemporary management of acute and chronic deep venous thrombosis

Abstract

Introduction: This review aims to provide an update on the management of deep vein thrombosis (DVT).

Sources of data: A systematic search of PubMed, Google Scholar and Cochrane databases was carried out.

Areas of agreement: Direct oral anticoagulants (DOACs) are as effective and easier to use than vitamin K antagonists for the treatment of DVT. Catheter-directed thrombolysis can reduce post thrombotic syndrome in patients with iliofemoral DVT. Compression bandaging can help heal a venous ulcer.

Areas of controversy: Compression hosiery to prevent post thrombotic syndrome. Long-term evidence to show clinical benefit of using endovenous therapies to restore deep vein patency.

Growing points: Developing imaging methods to identify patients who would benefit from venous thrombolysis. The evolution of dedicated venous stents.

Areas timely for developing research: Understanding the mechanisms that lead to stent occlusion and investigation into the appropriate treatments that could prevent in-stent thrombosis is required.

Keywords: DVT; catheter-directed lysis; endovenous; post-thrombotic syndrome; thrombolysis; venous stent.