{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:35:12Z","timestamp":1786707312947,"version":"build-2736575974"},"reference-count":30,"publisher":"Danish Medical Association","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ugeskr L\u00e6ger"],"abstract":"<jats:p>Endovenous procedures have been shown to offer an effective treatment for Iliofemoral deep venous thrombosis with a clinically relevant reduction in postthrombotic syndrome (PTS) compared to anticoagulation alone. Catheter-based thrombolysis reduces the risk of PTS but has been shown to cause periprocedural bleeding in about 3%. This review finds that mechanical thrombectomy has emerged as an ideal technique, with thrombus extraction without bleeding and a significant reduction in PTS at 12 months. A large randomised controlled trial including this technique versus anticoagulation is ongoing.<\/jats:p>","DOI":"10.61409\/v01260049","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T09:41:11Z","timestamp":1785922871000},"page":"1-8","source":"Crossref","is-referenced-by-count":0,"title":["Endovascular treatment of iliofemoral venous thrombosis"],"prefix":"10.61409","author":[{"given":"L\u00e6rke","family":"Urbak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f8rn Dalsgaard","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikkel","family":"Taudorf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren Thorup","family":"Heerwagen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaj","family":"Eldrup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"B\u00e6kgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"40208","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Prandoni P, Lensing AWA, Prins MH et al. Residual venous thrombosis as a predictive factor of recurrent venous thromboembolism. Ann Intern Med. 2002;137(12):955-60. https:\/\/doi.org\/10.7326\/0003-4819-137-12-200212170-00008","DOI":"10.7326\/0003-4819-137-12-200212170-00008"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Lui B, Wee B, Khattak Z et al. A 10-year review of iliofemoral deep vein thrombosis-are they more dangerous than their distal counterparts? J Thromb Thrombolysis. 2025. https:\/\/doi.org\/10.1007\/s11239-025-03170-7","DOI":"10.1007\/s11239-025-03170-7"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Iding AFJ, Kremers BMM, Robles AP et al. Residual venous obstruction as an indicator of clinical outcomes following deep vein thrombosis: a management study. Thromb Haemost. 2023;123(9):763-772. https:\/\/doi.org\/10.1055\/a-2059-4737","DOI":"10.1055\/a-2059-4737"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Siragusa S, Malato A, Saccullo G et al. Residual vein thrombosis for assessing duration of anticoagulation after unprovoked deep vein thrombosis of the lower limbs: the extended DACUS study. Am J Hematol. 2011;86(11):914-7. https:\/\/doi.org\/10.1002\/ajh.22156","DOI":"10.1002\/ajh.22156"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Turner BRH, Jasionowska S, Shea J et al. A systematic review and meta-analysis of the efficacy and safety of lytic and non-lytic early thrombus removal technologies for iliofemoral deep vein thrombosis. Ann Surg. 2026;283(2):225-233. https:\/\/doi.org\/10.1097\/SLA.0000000000006765","DOI":"10.1097\/SLA.0000000000006765"},{"key":"ref5","unstructured":"Broholm R, Just S, J\u00f8rgensen M, B\u00e6kgaard N. Akut iliofemoral ven\u00f8s trombose b\u00f8r behandles med kateterbaseret trombolyse. Ugeskr L\u00e6ger. 2012;174:930-933. https:\/\/ugeskriftet.dk\/videnskab\/akut-iliofemoral-venos-trombose-bor-behandles-med-kateterbaseret-trombolyse"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Madsen CP, Gesla J, Vijdea RL et al. Results of catheter-directed thrombolysis for acute ilio-femoral deep venous thrombosis-a retrospective cohort study. JRSM Cardiovasc Dis. 2018;7:2048004018766801. https:\/\/doi.org\/10.1177\/2048004018766801","DOI":"10.1177\/2048004018766801"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Foegh P, Jensen LP, Klitfod L et al. Editor's choice-factors associated with long-term outcome in 191 patients with ilio-femoral DVT treated with catheter-directed thrombolysis. Eur J Vasc Endovasc Surg. 2017;53(3):419-424. https:\/\/doi.org\/10.1016\/j.ejvs.2016.12.023","DOI":"10.1016\/j.ejvs.2016.12.023"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Engelberger RP, Stuck A, Spirk D et al. Ultrasound-assisted versus conventional catheter-directed thrombolysis for acute iliofemoral deep vein thrombosis: 1-year follow-up data of a randomized-controlled trial. J Thromb Haemost. 2017;15(7):1351-1360. https:\/\/doi.org\/10.1111\/jth.13709","DOI":"10.1111\/jth.13709"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Pouncey AL, Gwozdz AM, Johnson OW et al. AngioJet pharmacomechanical thrombectomy and catheter-directed thrombolysis vs catheter-directed thrombolysis alone for the treatment of iliofemoral deep vein thrombosis: a single centre retrospective cohort study. Eur J Vasc Endovasc Surg. 2020;60(4):578-585. https:\/\/doi.org\/10.1016\/j.ejvs.2020.05.006","DOI":"10.1016\/j.ejvs.2020.05.006"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Kakkos SK, Gohel M, Baekgaard N et al. Editor's choice-European Society for Vascular Surgery (ESVS) 2021 clinical practice guidelines on the management of venous thrombosis. Eur J Vasc Endovasc Surg. 2021;61(1):9-82. https:\/\/doi.org\/10.1016\/j.ejvs.2020.09.023","DOI":"10.1016\/j.ejvs.2020.09.023"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Broholm R, Sillesen H, Damsgaard MT et al. Postthrombotic syndrome and quality of life in patients with iliofemoral venous thrombosis treated with catheter-directed thrombolysis. J Vasc Surg. 2011;54(6 Suppl):18S-25S. https:\/\/doi.org\/10.1016\/j.jvs.2011.06.021","DOI":"10.1016\/j.jvs.2011.06.021"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Delomez M, Beregi JP, Willoteaux S et al. Mechanical thrombectomy in patients with deep venous thrombosis. Cardiovasc Intervent Radiol. 2001;24(1):42-8. https:\/\/doi.org\/10.1007\/s002700001658","DOI":"10.1007\/s002700001658"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Comerota AJ, Kearon C, Gu CS et al. Endovascular thrombus removal for acute iliofemoral deep vein thrombosis: analysis from a stratified multicenter randomized trial. Circulation. 2019;139(9):1162-1173. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.118.037425","DOI":"10.1161\/CIRCULATIONAHA.118.037425"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Dexter D, Kado H, Shaikh A et al. Safety and effectiveness of mechanical thrombectomy from the fully enrolled multicenter, prospective CLOUT registry. J Soc Cardiovasc Angiogr Interv. 2023;2(2):100585. https:\/\/doi.org\/10.1016\/j.jscai.2023.100585","DOI":"10.1016\/j.jscai.2023.100585"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Abramowitz S, Shaikh A, Mojibian H et al. Comparison of anticoagulation vs mechanical thrombectomy for the treatment of iliofemoral deep vein thrombosis. J Vasc Surg Venous Lymphat Disord. 2024;12(4):101825. https:\/\/doi.org\/10.1016\/j.jvsv.2024.101825","DOI":"10.1016\/j.jvsv.2024.101825"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Abramowitz SD, Marko X, D'Souza D et al. Rationale and design of the DEFIANCE study: a randomized controlled trial of mechanical thrombectomy versus anticoagulation alone for iliofemoral deep vein thrombosis. Am Heart J. 2025;281:92-102. https:\/\/doi.org\/10.1016\/j.ahj.2024.10.016","DOI":"10.1016\/j.ahj.2024.10.016"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Black SA, Gohel M, de Graaf R et al. Editor's choice - management of lower extremity venous outflow obstruction: results of an international Delphi consensus. Eur J Vasc Endovasc Surg. 2024;67(2):341-350. https:\/\/doi.org\/10.1016\/j.ejvs.2023.09.044","DOI":"10.1016\/j.ejvs.2023.09.044"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Enden T, Haig Y, Kl\u00f8w NE et al. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomized controlled trial. Lancet. 2012;379(9810):31-8. https:\/\/doi.org\/10.1016\/S0140-6736(11)61753-4","DOI":"10.1016\/S0140-6736(11)61753-4"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Avgerinos ED, Black S, van Rijn MJ et al. The role and principles of stenting in acute iliofemoral venous thrombosis. J Vasc Surg Venous Lymphat Disord. 2024;12(5):101868. https:\/\/doi.org\/10.1016\/j.jvsv.2024.101868","DOI":"10.1016\/j.jvsv.2024.101868"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Cervi AL, Applegate D, Stevens SM et al. Antithrombotic management of patients with deep vein thrombosis and venous stents: an international registry. J Thromb Haemost. 2023;21(12):3581-3588. https:\/\/doi.org\/10.1016\/j.jtha.2023.09.008","DOI":"10.1016\/j.jtha.2023.09.008"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Notten P, van Laanen JHH, Eijgenraam P et al. Quality of anticoagulant therapy and the incidence of in-stent thrombosis after venous stenting. Res Pract Thromb Haemost. 2020;4(4):594-603. https:\/\/doi.org\/10.1002\/rth2.12330","DOI":"10.1002\/rth2.12330"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Kishore S, Khaja MS, Thornburg B et al. Antithrombotic therapy after venous interventions: AJR expert panel narrative review. Am J Roentgenol. 2022;219(2):175-187. https:\/\/doi.org\/10.2214\/AJR.22.27413","DOI":"10.2214\/AJR.22.27413"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Notten P, Ten Cate H, Ten Cate-Hoek AJ. Postinterventional antithrombotic management after venous stenting of the iliofemoral tract in acute and chronic thrombosis: a systematic review. J Thromb Haemost. 2021;19(3):753-796. https:\/\/doi.org\/10.1111\/jth.15197","DOI":"10.1111\/jth.15197"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Skeik N, Li R, Cravero E et al. Antithrombotic therapies for patients with acute iliofemoral deep vein thrombosis following endovenous recanalization: a single-center study and literature review. Phlebology. 2025;40(8):570-580. https:\/\/doi.org\/10.1177\/02683555251321903","DOI":"10.1177\/02683555251321903"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Barco S, Jalaie H, Sebastian T et al. Aspirin plus rivaroxaban versus rivaroxaban alone for the prevention of venous stent thrombosis among patients with post-thrombotic syndrome: the multicenter, multinational, randomized, open-label ARIVA trial. Circulation. 2025;151(12):835-846. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.124.073050","DOI":"10.1161\/CIRCULATIONAHA.124.073050"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Nielsen JD, Hermann TS, Fredskilde PCA. Graduated elastic compression stockings in the prevention of post-thrombotic syndrome: a systematic review and meta-analysis. Phlebology. 2024;39(4):229-237. https:\/\/doi.org\/10.1177\/02683555231225268","DOI":"10.1177\/02683555231225268"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Hupperetz R, Cate-Hoek AT. The postthrombotic syndrome, where are we now? Vasa. 2025;54(1):7-19. https:\/\/doi.org\/10.1024\/0301-1526\/a001156","DOI":"10.1024\/0301-1526\/a001156"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"Bisharat MB, Ichinose EJ, Veerina KK et al. One-year clinical outcomes following mechanical thrombectomy for deep vein thrombosis: a CLOUT registry analysis. J Soc Cardiovasc Angiogr Interv. 2024;3(3Part A):101307. https:\/\/doi.org\/10.1016\/j.jscai.2024.101307","DOI":"10.1016\/j.jscai.2024.101307"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"B\u00e6kgaard N, Black SA, Gohel MS. Status of early thrombus removal for iliofemoral deep venous thrombosis: catheter based thrombolysis should be largely obsolete. Eur J Vasc Endovasc Surg. 2025;70(5):564-566. https:\/\/doi.org\/10.1016\/j.ejvs.2025.06.055","DOI":"10.1016\/j.ejvs.2025.06.055"}],"container-title":["Ugeskrift for L\u00e6ger"],"original-title":[],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:04:53Z","timestamp":1786705493000},"score":1,"resource":{"primary":{"URL":"https:\/\/ugeskriftet.dk\/videnskab\/V01260049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":30,"URL":"https:\/\/doi.org\/10.61409\/v01260049","relation":{},"ISSN":["0041-5782","1603-6824"],"issn-type":[{"value":"0041-5782","type":"print"},{"value":"1603-6824","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]}}}