Venous Thromboembolic Disease

Venous thromboembolic (VTE) disease is a significant cause of morbidity andmortality worldwide. Annual incidence of VTE is estimated to be as high as 1 million cases per year in the United States alone, and with the increase in the elderly and obese populations, this number is expected to rise. Traditionally, VTE has been treated with systemic anticoagulation, with the primary goals of preventing propagation of thrombus, development of pulmonary embolism (PE), and recurrence of VTE. However, the late manifestations of VTE, notably post-thrombotic syndrome (PTS), are being increasingly recognized. Subsequently, the management of VTE in preventing its long-term sequelae is being scrutinized. Much data exist that demonstrate the ineffectiveness of conventional anticoagulation in preventing such sequelae. As such, there has been an effort to evaluate the use of catheter-directed thrombolysis and reintroduce surgical thrombectomy for the treatment of VTE. Simply put, thrombus develops as a result of stasis, endothelial injury, and an imbalance between the coagulation and fibrinolytic systems, collectively known as Virchow