Gastrointestinal Malignancies and Venous Thromboembolic Disease: Clinical Significance and Endovascular Interventions.
Gastrointestinal Malignancies and Venous Thromboembolic Disease: Clinical Significance and Endovascular Interventions.
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DOI：
10.1055/s-0040-1716739
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Vedantham S
中科院分区：
文献类型：
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作者：
Li X;Partovi S;Gadani S;Martin C 3rd;Beck A;Vedantham S
胃肠道恶性肿瘤包括广泛的疾病过程。它的发病率和死亡率是所有癌症中最高的。静脉血栓栓塞性疾病是胃肠道恶性肿瘤的常见并发症。抗凝仍然是一线治疗。然而，对于不能耐受或抗凝失败的患者，下腔静脉（IVC）过滤器放置可能是一种选择。此外，为了改善症状缓解和降低血栓后综合征的严重程度，导管定向溶栓（CDT）可能是一种选择。最近的随机试验，包括急性静脉血栓形成：血栓清除与辅助导管定向溶栓试验，揭示了CDT及其相关方法的有效性和安全性。总的来说，决定进行IVC过滤器放置或CDT必须个性化。
Gastrointestinal malignancy encompasses a wide range of disease processes. Its incidence and mortality rate rank among the highest of all cancers. Venous thromboembolic disease is a common complication of gastrointestinal malignancy. Anticoagulation remains the first-line therapy. However, for patients who cannot tolerate or have failed anticoagulation, inferior vena cava (IVC) filter placement may be an option. Furthermore, to improve symptom resolution and reduce the severity of postthrombotic syndrome, catheter-directed thrombolysis (CDT) may be an option. Recent randomized trials including the ATTRACT (Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis) trial have shed new light on the efficacy and safety of CDT and related methods. Overall, the decision to proceed with IVC filter placement or CDT must be individualized.