The role of thrombolysis in the clinical management of deep vein thrombosis.
The role of thrombolysis in the clinical management of deep vein thrombosis.
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DOI：
10.1161/atvbaha.110.213413
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发表时间：
2011-03
期刊：
影响因子：
--
通讯作者：
Vedantham S
中科院分区：
文献类型：
--
作者：
Popuri RK;Vedantham S
当前深静脉血栓 (DVT) 治疗的基石是常规使用抗凝治疗、分级弹性压力袜 (ECS) 和早期下床活动。溶栓治疗以前仅用于出现危及生命、肢体或器官的并发症的患者。然而，血栓后综合症（PTS）已越来越被认为是 DVT 的常见且严重的长期并发症。与此同时，血管内溶栓方法近年来有了长足的发展，引发了关于是否应该更广泛地使用它们的讨论和争议。在一些中心，药物机械导管定向溶栓 (PCDT) 现在常规用于治疗急性髂股 DVT。目前正在进行随机试验，以确定何时适合急性近端 DVT 患者使用 PCDT。
The cornerstones of current management of deep vein thrombosis (DVT) are the routine use of anticoagulant therapy, graduated elastic compression stockings (ECS), and early ambulation. Thrombolytic therapy was previously reserved only for patients with life-, limb-, or organ-threatening complications. However, the Post-Thrombotic Syndrome (PTS) has been increasingly recognized as a frequent and serious long-term complication of DVT. In parallel, endovascular thrombolytic methods have evolved considerably in recent years, prompting discussion and controversy as to whether they should be more liberally employed. In some centers, Pharmacomechanical Catheter-Directed Thrombolysis (PCDT) is now routinely used in the treatment of acute iliofemoral DVT. Randomized trials are currently underway to determine when the use of PCDT is appropriate in patients presenting with acute proximal DVT.