Abstract
Large-bore thrombectomy has emerged as a critical treatment option in the management
of iliocaval thrombosis, a condition associated with high morbidity and mortality.
These devices are designed for rapid removal of clot and symptom resolution while
minimizing the need for thrombolytic therapy. Ongoing trials, prospective registries,
and retrospective reviews are also investigating the role of early thrombectomy or
thrombolysis on subsequent development of post-thrombotic syndrome. These interventions
are particularly beneficial for patients with contraindications to systemic or catheter-directed
thrombolysis, those at high risk for post-thrombotic syndrome, or those with chronic
thrombus, which is less likely to respond to lytic therapy.
These devices utilize mechanical, aspiration, and rotatory systems to break up and
remove acute and chronic, densely adherent thrombus. Each has unique characteristics
that make them preferred in different disease states and many cases require use of
multiple devices in conjunction with one another. This review describes the importance
of large-bore thrombectomy in the treatment of iliocaval thromboembolic disease and
highlights modern devices and case-specific uses for each.
Keywords
thrombosis - large-bore thrombectomy - iliocaval thromboembolism - aspiration thrombectomy
- mechanical thrombectomy - interventional radiology
