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Abstract Deep venous thrombosis is a significant cause of morbidity and mortality. It has been estimated that the yearly incidence of deep venous thrombosis is high and many individuals die annually from pulmonary emboli. In addition to early risk of pulmonary emboli, later morbidity may develop from recurrent thrombosis and post thrombotic syndrome. Inferior vena cava filters can effectively decrease the incidence of fatal pulmonary emboli. Although conventional anticoagulation therapy has been proven effective in the treatment of deep venous thrombosis and pulmonary emboli, the incidence of recurrent deep venous thrombosis (2–10%) and post-thrombotic syndrome (20–50%) is fairly high after the first episode. Moreover, venous valvular insufficiency is not uncommon: there are reports in the literature of incidences as high as 100% after the primary deep venous thrombosis event. Endovascular deep venous thrombosis thrombolysis offers the potential to provide faster relief of presenting deep venous thrombosis symptoms and to prevent post-thrombotic syndrome and its associated major disability. Urgent thrombolysis is required to treat phlegmasia cerula dolens or progressive inferior vena cava thrombosis. Thrombolysis may also be useful to prevent post thrombotic syndrome. Thrombolysis alone, mechanical devices alone, or a combination Can be used; also can insert stents in the thrombotic part. To confirm that existing percutaneous methods of treating acute deep venous thrombosis indeed produce favorable outcomes, we urgently need supporting randomized clinical trials. Until they are completed, a highly individualized approach to patient selection optimizes clinical benefit. |