AVF Session: DVT Thrombectomy, SVT, and EHIT Updates

Single-Session Mechanical Thrombectomy for Iliofemoral DVT

Modern aspiration and clot-retrieval devices now achieve wall-to-wall iliofemoral thrombectomy in about an hour with little to no thrombolytic, cutting the bleeding risk tied to pharmacomechanical lysis. Dual clot-detection systems adjust aspiration automatically, and a case example shows single-access management of caval filter thrombus and iliofemoral clot.

Superficial Venous Thrombosis Guidelines

Updated chest guidelines support anticoagulation over serial imaging for superficial venous thrombosis with extensive above-knee involvement, severe symptoms, or prior thromboembolic history, while lower-risk segments can be followed with serial duplex. Cost and travel burden for repeat imaging should factor into the shared decision made with each patient.

Renaming and Managing EHIT as ART

Endovenous heat-induced thrombus extension is being renamed ablation-related thrombus extension to reflect nonthermal closure methods. Combined classification systems now guide management: low-grade extension needs only observation or antiplatelet therapy, while extension past fifty percent of the deep lumen warrants therapeutic anticoagulation, and routine universal post-ablation duplex is no longer cost-effective for low-risk patients.