Explore an in-depth lecture on endovascular therapy for deep vein thrombosis, delivered by Dr. Suresh Vedantham at Yale Interventional Radiology Grand Rounds. Delve into the evidence, observations, and truths surrounding this treatment approach, covering topics such as acute deep vein thrombosis, standard therapies, post-thrombotic syndrome, and the open vein hypothesis. Examine key clinical trials like CAVENT and ATTRACT, and discuss patient selection criteria for lysis treatment. Gain insights into infusion-first catheter-directed thrombolysis, fast single-session therapy, and the challenges facing endovascular therapy in post-thrombotic syndrome care. Enhance your understanding of this evolving field in interventional radiology through this comprehensive 51-minute presentation.
Endovascular Therapy for Deep Vein Thrombosis: Evidence, Observation, and Truth
Overview
Syllabus
Intro
DISCLOSURES
Transition: Observation = Evidence
"Acute Deep Vein Thrombosis" Acute Phase of a Chronic Disease
Standard DVT Therapy
Biology: Post-Thrombotic Syndrome
The Open Vein Hypothesis
Observation (logic and emotion)
Distinguishing Clinical Scenarios
CAVENT: CDT May Prevent PTS
The ATTRACT Movement
Pre-Specified Subgroups
Patients with Iliofemoral DVT Comerota AJ et al, Circulation 2019
ATTRACT Cost-Effectiveness
CAVA TRIAL (IFDVT; UA-CDT) C. Wittens et al: AVF Meeting 2019
2019 - Who Should Be Lysed?
Infusion-First CDT
Fast Single-Session Therapy
The Disease: Open Vein Hypothesis
Pursuing Chronic DVT/PTS Disabling Symptoms/Signs/Ulcer
Threats to EVT's Future for PTS Care
Finding and Following (but not Fearing) the Truth
The End of the Beginning
Taught by
Yale Radiology and Biomedical Imaging
