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Semin intervent Radiol
DOI: 10.1055/s-0045-1810081
Review Article

Pediatric Venous Thromboembolism: Considerations for the Interventional Radiologist

William Mitchell
1   Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
,
Michael H. White
1   Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
,
Prashant Raghavendran
1   Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
,
Gary Woods
1   Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
,
Karen L. Zimowski
1   Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
› Author Affiliations
Funding KLZ acknowledges support from the NICHD Child Health Research Career Development Award Program, K12HD072245 Atlanta Pediatric Scholars Program.
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Abstract

Pediatric venous thromboembolism (VTE) has seen a significant rise in prevalence coinciding with the increasing availability of complex and invasive treatments in children. While anticoagulation remains the cornerstone of VTE treatment, increasing evidence supports interventional approaches for select cases, particularly in life- or limb-threatening scenarios. Treatment strategies must be individualized, considering age-related differences in hemostasis and the higher bleeding risk associated with interventions. This remains challenging due to a dearth of pediatric-specific studies. This manuscript explores pathophysiology, risk factors, and management strategies for pediatric VTE, emphasizing both pharmacologic and interventional treatments and providing updated recommendations regarding available anticoagulant agents and VTE management paradigms in children. It highlights the potential of interventional techniques in special conditions, namely Paget–Schroetter syndrome, superior vena cava syndrome, inferior vena cava atresia, pulmonary emboli, and May–Thurner syndrome. In the absence of rigorous clinical trial data, continued multidisciplinary collaboration and standardized approaches will remain imperative for ensuring careful use of interventional procedures to achieve optimal outcomes in these young patients.

Keywords

pediatric - venous thromboembolism - pulmonary embolism - interventional radiology - anticoagulation - thrombolysis - thrombectomy


Publication History

Article published online:
17 July 2025

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Bibliographical Record
William Mitchell, Michael H. White, Prashant Raghavendran, Gary Woods, Karen L. Zimowski. Pediatric Venous Thromboembolism: Considerations for the Interventional Radiologist. Semin intervent Radiol ; : s00451810081.
DOI: 10.1055/s-0045-1810081