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Haqqani O. P. 1, Aized M. T. 2, Iafrati M. D. 3
1 Unit of Vascular Surgery, Department of Surgery, MidMichigan Health, University of Michigan Health System, Midland, TX, USA;
2 Unit of Vascular Surgery, Department of Surgery, Detroit Medical Center, Detroit, MI, USA;
3 Vascular Surgery, Department of Surgery, Tufts Medical Center, Boston, MA, USA
Acute lower extremity deep venous thrombosis (DVT) is a common disease that can result in death from pulmonary embolism or significant morbidity from chronic venous insufficiency. Modern management of acute lower extremity DVT requires a thorough knowledge of various diagnostic and treatment options. Unfortunately many physicians treat all patients with acute DVT with anticoagulation alone, despite evidence that post thrombotic chronic venous insufficiency, leg ulceration and venous claudication are common in patients treated with anticoagulation alone. Contemporary evidence based management of acute lower extremity DVT has focused on the cessation and removal of acute thrombus burdens when possible. Venous thrombectomy, intrathrombus catheter-directed thrombolysis and pharmacomechanical thrombolysis are options that can successfully remove venous thrombus with increasing safety. The authors review evidence and guidelines regarding the diagnostic and therapeutic options for DVT, including anticoagulation and acute thrombus removal.