Evid Based Med 17:182-183 doi:10.1136/ebmed-2012-100673
  • Therapeutics

Catheter-directed thrombolysis prevents post-thrombotic syndrome in patients with acute deep vein thrombosis in the upper half of the thigh

  1. Anthony J Comerota
  1. Jobst Vascular Institute and University of Michigan, Toledo, Ohio, USA
  1. Correspondence to: Anthony J Comerota
    Jobst Vascular Institute and University of Michigan, 2109 Hughes Dr, Suite 400, Toledo, OH 43606, USA; marilyn.gravett{at}

Commentary on:


Post-thrombotic syndrome (PTS) can be a debilitating consequence of acute deep venous thrombosis (DVT). The subset of patients with iliofemoral DVT represents a particularly high-risk cohort of patients likely to develop PTS.1 Anatomically, the common femoral, external iliac and common iliac veins represent the single venous outflow tract from the lower extremity and, when acutely occluded, result in high venous and compartment pressures.2 Sustained venous hypertension, specifically ambulatory venous hypertension, is the underlying pathophysiology of chronic post-thrombotic venous disease.

Treatment strategies which eliminate clot and restore unobstructed venous drainage to the vena cava have resulted in …

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