Clinical Drug Experience Knowledgebase

Criteria

Inclusion Criteria include:

Patients with radiographically-confirmed acute proximal DVT

Exclusion Criteria include:

Isolated calf or popliteal vein DVT, based on duplex ultrasound
Thrombus involving the inferior vena cava (IVC)
Proximal (e.g. cranial) aspect of thrombus cannot be adequately assessed to level of the iliac veins or inferior vena cava, based on duplex ultrasound.
Cannot traverse the target vessel segment with guidewire
Symptomatic pulmonary embolism is present at time of presentation
Documented history of prior DVT in target extremity
History of anticoagulants administered for > 30 days for undocumented/ unclear reason (e.g. for reasons other than presence of mechanical cardiac valve, atrial fibrillation, etc.)
Documented history of thrombophilic disorder, with diagnosis established via previous objective testing (e.g. familial screening for thrombophilia).
Cannot receive standard secondary prevention pharmacotherapy [i.e. heparin or LMWH and vitamin K antagonists (VKA)] due to contraindications to anticoagulation [e.g. known bleeding diathesis, thrombocytopenia (platelets < 100,000 mm3), heparin induced thrombocytopenia (HIT), known allergy to heparin or warfarin]
Absolute contraindication to thrombolytic therapy
Previous central nervous system haemorrhage
Life expectancy less than 1 year, due to other comorbid condition.
Previous intervention in target limb to address venous thrombus.
Target limb has chronic venous insufficiency of C4 or greater severity
Acute or chronic symptomatic musculoskeletal condition in target limb (e.g. trauma, fracture, severe arthritis).
Documented patent foramen ovale or other right-to-left cardiac shunt.
Absolute contraindication to contrast media or renal insufficiency (baseline creatinine >2.0 mg/dL).