Digestive Disease Interventions 2020; 04(03): 260-266
DOI: 10.1055/s-0040-1716739
Review Article

Gastrointestinal Malignancies and Venous Thromboembolic Disease: Clinical Significance and Endovascular Interventions

Xin Li
1  Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, Ohio
,
Sasan Partovi
1  Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, Ohio
,
Sameer Gadani
1  Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, Ohio
,
Charles Martin III
1  Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, Ohio
,
Avi Beck
1  Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, Ohio
,
Suresh Vedantham
2  Section of Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri
› Author Affiliations
Funding The authors' effort was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number TL1TR002344 (ST) and by the National Heart Lung and Blood Institute grant UH3-HL138325 for the C-TRACT Clinical Trial. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Abstract

Gastrointestinal malignancy encompasses a wide range of disease processes. Its incidence and mortality rate rank among the highest of all cancers. Venous thromboembolic disease is a common complication of gastrointestinal malignancy. Anticoagulation remains the first-line therapy. However, for patients who cannot tolerate or have failed anticoagulation, inferior vena cava (IVC) filter placement may be an option. Furthermore, to improve symptom resolution and reduce the severity of postthrombotic syndrome, catheter-directed thrombolysis (CDT) may be an option. Recent randomized trials including the ATTRACT (Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis) trial have shed new light on the efficacy and safety of CDT and related methods. Overall, the decision to proceed with IVC filter placement or CDT must be individualized.



Publication History

Received: 19 June 2020

Accepted: 27 July 2020

Publication Date:
22 September 2020 (online)

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