Abstract
This study aims to review current practices in thrombolysis and thrombectomy for managing
deep venous thrombosis (DVT) and associated complications in the pediatric population.
Pediatric thrombosis care has a rich history of evolution, from the early days of
anticoagulation to the current era of endovascular therapies. This evolution has been
driven by the need for a nuanced, multidisciplinary approach that includes interventional
radiology (IR) and hematology. While anticoagulation remains the standard of care,
endovascular therapies are increasingly utilized in cases of extensive, occlusive,
or limb-threatening DVT, particularly to prevent pulmonary embolism and postthrombotic
syndrome (PTS) and to preserve venous patency. This review outlines the indications,
contraindications, and procedural techniques for catheter-directed thrombolysis, pharmaco-mechanical
thrombectomy (PMT), mechanical thrombectomy, and venous stenting in children. It emphasizes
the crucial role of a multidisciplinary team, including pediatric hematologists, interventional
radiologists, and other medical professionals, in managing pediatric DVT. This collaboration
is essential for considering pediatric-specific factors such as patient size, sedation
requirements, radiation, contrast dosing, and anticoagulation. Also highlighted are
postprocedural care, anticoagulation strategies, and imaging follow-up. Multidisciplinary
collaboration is critical to improving outcomes for children with thrombotic disease.
Keywords
pediatric - DVT - thrombolysis - thrombectomy - anticoagulation
