Deep Vein Thrombosis

Deep Vein Thrombosis Hub

Deep Vein Thrombosis (DVT) is a serious and potentially disabling condition, often leading to long-term complications if not treated effectively. Almost half of patients diagnosed with DVT are at risk of developing Post-Thrombotic Syndrome (PTS), a chronic condition that can significantly affect their quality of life. Many individuals with PTS find it difficult to maintain employment years after their diagnosis, and a portion may experience venous leg ulcers, resulting in a quality of life that can be comparable to those living with serious health conditions like heart failure or cancer.

Despite these severe outcomes, traditional treatment methods often leave behind residual clot, significantly increasing the risk of recurrent DVT and PTS. Research shows that venous clots become more resistant to lysis by the time of treatment, and conservative management fails a significant portion of the time, particularly in chronic cases^1-2.

This section brings together key clinical papers, case studies, and expert interviews discussing why early intervention, including mechanical thrombectomy, is essential to restore vein patency, preserve valvular function, and reduce the long-term complications of DVT, such as PTS and pulmonary embolism. By tackling DVT at its root, new treatment approaches are offering hope to patients who are at risk of debilitating outcomes.

_References:

_{1. Silver, et al. Histopathologic analysis of extracted thrombi from deep venous thrombosis and pulmonary embolism: Mechanisms and timing. Catheter Cardiovasc Interv. 2021 Jun 1;97(7):1422-1429.}
_{2. Czaplicki, et al. Can thrombus age guide thrombolytic therapy? Cardiovasc Diagn Ther. 2017 Dec;7(Suppl 3):S186-S196.}

Endorsed by Dr Emma Wilton (Vascular Surgeon at the Oxford University Hospitals NHS Foundation Trust, Oxford, UK).
Effective DVT management goes beyond short-term treatment. Early intervention is critical to prevent life-altering complications like post-thrombotic syndrome, ensuring a better quality of life for our patients.

The Deep Vein Thrombosis Hub is supported by

Highlights

VIO 2023 - Why treat acute DVT with a Lytic-Free Intervention?

Prof Efthymios Avgerinos discusses the desired outcomes of DVT interventions and explores the structural changes in venous thrombus. He also reviews a case study of a 61-year-old male and explains the use of the clot removal catheter.

VIO 2023 - Does age matter for clots? Treating the full range of DVT with the ClotTriever system

Dr Emma Wilton discusses the chronicity and morphology of thrombus as background. She then explores when to intervene with the patient, considering the factors involved and supports her points with local data on the ClotTriever device. Following this, she presents various case studies with different symptoms and swelling to demonstrate thrombus clearance using the clot treatment device

VIO 2023 - How Existing and Future Clinical Data will Impact the Treatment of Acute DVT?

Prof Stephen Black explores DVT studies, with a focus on the Defiance Study. He discusses the key eligibility criteria and treatment arms of the study, as well as the assessment of treatment effectiveness and the implications of the Defiance Study. Finally, Prof Efthymios Avgerinos, Dr Emma Wilton and Professor Stephen Black address audience questions.

Why to Intervene?

Consequences of Leaving Clot Behind

Dr Marie-Josee Van Rijn discusses the critical importance of interventional treatment for Deep Vein Thrombosis (DVT). She outlines key symptoms to watch for and highlights common challenges associated with DVT management.

Managing the Full Range of DVT

Dr Andrew Wigham discusses cost-effective methods for managing DVT, strategies to mitigate the risks of thrombolytic therapy, and how to identify patients before they enter their acute phase.

Benefits of the Mechanical Thrombectomy

Dr Michael Lichtenberg emphasises the importance of clot removal for patients suffering from DVT and highlights the significant outcomes of the Arnsberg ClotTriever Study.

Effective Therapies for VTE

Dr Rashid Akhtar and Dr Michael Kostrzewa examine the growing prevalence of interventional treatment for PE and DVT. They also discuss the key benefits of the FlowTriever® and ClotTriever® systems, addressing their effectiveness in patient care.

Building a DVT Pathway

Oxford University Hospitals Experience

Learn how mechanical thrombectomy has advanced patient care and DVT management at Oxford University Hospitals, with insights from Dr Emma Wilton, Vascular Surgeon.

Clinical Updates

Importance of CLOUT & DEFIANCE

Dr Steven Abramowitz and Prof Stephen Black explore how the CLOUT registry and the DEFIANCE randomised controlled trial could revolutionise data collection and patient outcomes, highlighting their significance in shaping the future of vascular care.

VIO 2023 - Why treat acute DVT with a Lytic-Free Intervention?

VIO 2023 - Does age matter for clots? Treating the full range of DVT with the ClotTriever system

Dr Emma Wilton discusses the chronicity and morphology of thrombus as background. She then explores when to intervene with the patient, considering the factors involved, and supports her points with local data on the ClotTriever device. Following this, she presents various case studies with different symptoms and swelling to demonstrate thrombus clearance using the clot treatment device

VIO 2023 - How Existing and Future Clinical Data will Impact the Treatment of Acute DVT?

Prof Stephen Black explores DVT studies, with a focus on the Defiance Study. He discusses the key eligibility criteria and treatment arms of the study, as well as the assessment of treatment effectiveness and the implications of the Defiance Study. Finally, Prof Efthymios Avgerinos, Dr Emma Wilton, and Professor Stephen Black address audience questions.

VIO 2022 - Comprehensive Patient Assessment

Comprehensive Patient Assessment

Dr Marie-Josee van Rijn discusses an acute DVT case of a 68-year-old female with a history of anamnesis. After a duplex investigation and CT scan, treatment options were discussed, and the final decision was to opt for thrombectomy.

VIO 2022 - Introduction to ClotTriever & Key Insights from CLOUT Data

Introduction to ClotTriever & Key Insights from CLOUT Data

Dr Marie-Josee van Rijn discusses the thrombectomy treatment option using the ClotTriever and covers the positive safety and long-term outcomes of DVT treatment with the device

VIO 2022 - Case Presentation & Clinical Considerations

Dr van Rijn emphasizes the importance of patient selection and describes the procedural steps and post-procedural care. She highlights the device's safety, reporting low complication rates and stressing that operator experience is crucial for success. The segment concludes with Dr van Rijn discussing the promising long-term outcomes for DVT patients treated with the ClotTriever, including improvements in quality of life and a reduced risk of post-thrombotic syndrome.

VIO 2022 - Expert Panel Discussion

Dr Marie-Josee van Rijn discusses the use of the ClotTriever device for thrombectomy in treating acute deep vein thrombosis (DVT). She highlights its effectiveness in iliofemoral DVT cases, particularly for patients with symptoms like swelling and pain. Dr Nicos Labropoulo and Dr Karem Harth also provides their insights on the stent and clinical updates. Dr O'Sullivan provides advise from his past experience using the stent and discusses an open lesion.

VIO 2022 - Case Conclusion & Key Takeaways

The panel discusses the case in further detail and various factors which posed as an advantage.

VIO 2022 - Closing Remarks

The panel discusses the case in further detail and various factors which posed as an advantage.

Mechanical Thrombectomy in Action

Case Report — Kantonsspital Baden

Dr Michael Kostrzewa walks through patient’s symptoms, diagnosis and outlines the treatment strategy used to successfully remove the clot.

Case Report — Erasmus Medical Centre

The Erasmus Medical Centre presents a detailed patient case, highlighting the decision-making process and treatment outcomes for deep vein thrombosis (DVT).

Case Report — Oxford University Hospitals (1)

A patient case from Oxford University Hospitals showcases the innovative management of chronic venous thrombosis (CVT) in a patient with debilitating leg swelling and persistent symptoms despite prior treatments. The case highlights advanced care for a challenging condition.

Case Report — Oxford University Hospitals (2)

A patient case from Oxford University Hospitals highlights the diagnosis and management of acute iliofemoral DVT in a 31-year-old man with left leg swelling and May-Thurner compression. The case showcases advanced treatment strategies and clinical decision-making.

Patient Stories

Patient Story - Luise Gorki

Learn how Dr Michael Piorkowski (Cardiovascular Center Bethanien, Frankfurt, DE) used the ClotTriever® device to effectively treat Luise’s condition, offering a personalised approach to her care.