Intravascular Ultrasound Findings in Acute and Chronic Deep Vein Thrombosis of the Lower Extremities
Deep vein thrombosis (DVT) of the lower extremities, as part of venous thromboembolism disorder, is the third leading cause of acute cardiovascular syndrome after heart attack and stroke. It can result in disability due to pulmonary embolism (PE) and post-thrombotic syndrome (PTS), particularly in c...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-02-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/15/5/577 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850225253690638336 |
|---|---|
| author | Fabio Corvino Francesco Giurazza Massimo Galia Antonio Corvino Roberto Minici Antonio Basile Anna Maria Ierardi Paolo Marra Raffaella Niola |
| author_facet | Fabio Corvino Francesco Giurazza Massimo Galia Antonio Corvino Roberto Minici Antonio Basile Anna Maria Ierardi Paolo Marra Raffaella Niola |
| author_sort | Fabio Corvino |
| collection | DOAJ |
| description | Deep vein thrombosis (DVT) of the lower extremities, as part of venous thromboembolism disorder, is the third leading cause of acute cardiovascular syndrome after heart attack and stroke. It can result in disability due to pulmonary embolism (PE) and post-thrombotic syndrome (PTS), particularly in cases where the thrombosis extends to the iliofemoral veins. Anticoagulation therapy is effective in preventing thrombus propagation and embolism but may not be sufficient for thrombus degradation and venous patency restoration. Up to 50% of patients with iliofemoral DVT develop PTS, mainly due to venous outflow obstruction or valvular incompetence. To date, the advent of new devices that enables rapid thrombus elimination and the restoration of deep venous patency, known as the “OPEN VEIN hypothesis”, may prevent valvular damage and reflux, cutting down the rate of PTS. Similarly, chronic venous disease could be related to a stenosis or occlusion of a major vein that can restrict blood flow. In this setting, intravascular ultrasound (IVUS) is an essential tool for correct diagnostic and therapeutic planning in acute and chronic vein disease. Only angiography in vein disease can limit the procedure’s efficacy, with a high rate of stenosis misdiagnosed; IVUS provides further imaging that complements traditional angiographic study, and its role is now established by different international guidelines. If compared to angiography, IVUS allows for the evaluation of major axial veins in a 360-degree ultrasound image of the lumen and of the vessel wall structure. At the same time, the precise location and size of the major lower extremity veins allow for the placement of the stent to be more straightforward with a precise dimension of the vein in all of its diameters; moreover, other abnormalities should be visualized as acute or chronic thrombus, fibrosis, or trabeculations. This review aims to provide an in-depth analysis of IVUS findings in acute and chronic lower extremity DVT, emphasizing its diagnostic and therapeutic implications. |
| format | Article |
| id | doaj-art-a2c57138eaad4fd0b6d5701f1a9a8b84 |
| institution | OA Journals |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-a2c57138eaad4fd0b6d5701f1a9a8b842025-08-20T02:05:24ZengMDPI AGDiagnostics2075-44182025-02-0115557710.3390/diagnostics15050577Intravascular Ultrasound Findings in Acute and Chronic Deep Vein Thrombosis of the Lower ExtremitiesFabio Corvino0Francesco Giurazza1Massimo Galia2Antonio Corvino3Roberto Minici4Antonio Basile5Anna Maria Ierardi6Paolo Marra7Raffaella Niola8Interventional Radiology Department, AORN “A. Cardarelli”, 80131 Naples, ItalyInterventional Radiology Department, AORN “A. Cardarelli”, 80131 Naples, ItalySection of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, 90127 Palermo, ItalyMedical, Movement and Wellbeing Sciences Department, University of Naples “Parthenope”, 80133 Naples, ItalyRadiology Unit, University Hospital Dulbecco, 88100 Catanzaro, ItalyRadiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”, University Hospital “Policlinico-San Marco”, University of Catania, 95123 Catania, ItalyDepartment of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda-Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Radiology, Papa Giovanni XXIII Hospital, 24127 Bergamo, ItalyInterventional Radiology Department, AORN “A. Cardarelli”, 80131 Naples, ItalyDeep vein thrombosis (DVT) of the lower extremities, as part of venous thromboembolism disorder, is the third leading cause of acute cardiovascular syndrome after heart attack and stroke. It can result in disability due to pulmonary embolism (PE) and post-thrombotic syndrome (PTS), particularly in cases where the thrombosis extends to the iliofemoral veins. Anticoagulation therapy is effective in preventing thrombus propagation and embolism but may not be sufficient for thrombus degradation and venous patency restoration. Up to 50% of patients with iliofemoral DVT develop PTS, mainly due to venous outflow obstruction or valvular incompetence. To date, the advent of new devices that enables rapid thrombus elimination and the restoration of deep venous patency, known as the “OPEN VEIN hypothesis”, may prevent valvular damage and reflux, cutting down the rate of PTS. Similarly, chronic venous disease could be related to a stenosis or occlusion of a major vein that can restrict blood flow. In this setting, intravascular ultrasound (IVUS) is an essential tool for correct diagnostic and therapeutic planning in acute and chronic vein disease. Only angiography in vein disease can limit the procedure’s efficacy, with a high rate of stenosis misdiagnosed; IVUS provides further imaging that complements traditional angiographic study, and its role is now established by different international guidelines. If compared to angiography, IVUS allows for the evaluation of major axial veins in a 360-degree ultrasound image of the lumen and of the vessel wall structure. At the same time, the precise location and size of the major lower extremity veins allow for the placement of the stent to be more straightforward with a precise dimension of the vein in all of its diameters; moreover, other abnormalities should be visualized as acute or chronic thrombus, fibrosis, or trabeculations. This review aims to provide an in-depth analysis of IVUS findings in acute and chronic lower extremity DVT, emphasizing its diagnostic and therapeutic implications.https://www.mdpi.com/2075-4418/15/5/577intravascular ultrasound (IVUS)thrombosisdeep vein thrombosis |
| spellingShingle | Fabio Corvino Francesco Giurazza Massimo Galia Antonio Corvino Roberto Minici Antonio Basile Anna Maria Ierardi Paolo Marra Raffaella Niola Intravascular Ultrasound Findings in Acute and Chronic Deep Vein Thrombosis of the Lower Extremities Diagnostics intravascular ultrasound (IVUS) thrombosis deep vein thrombosis |
| title | Intravascular Ultrasound Findings in Acute and Chronic Deep Vein Thrombosis of the Lower Extremities |
| title_full | Intravascular Ultrasound Findings in Acute and Chronic Deep Vein Thrombosis of the Lower Extremities |
| title_fullStr | Intravascular Ultrasound Findings in Acute and Chronic Deep Vein Thrombosis of the Lower Extremities |
| title_full_unstemmed | Intravascular Ultrasound Findings in Acute and Chronic Deep Vein Thrombosis of the Lower Extremities |
| title_short | Intravascular Ultrasound Findings in Acute and Chronic Deep Vein Thrombosis of the Lower Extremities |
| title_sort | intravascular ultrasound findings in acute and chronic deep vein thrombosis of the lower extremities |
| topic | intravascular ultrasound (IVUS) thrombosis deep vein thrombosis |
| url | https://www.mdpi.com/2075-4418/15/5/577 |
| work_keys_str_mv | AT fabiocorvino intravascularultrasoundfindingsinacuteandchronicdeepveinthrombosisofthelowerextremities AT francescogiurazza intravascularultrasoundfindingsinacuteandchronicdeepveinthrombosisofthelowerextremities AT massimogalia intravascularultrasoundfindingsinacuteandchronicdeepveinthrombosisofthelowerextremities AT antoniocorvino intravascularultrasoundfindingsinacuteandchronicdeepveinthrombosisofthelowerextremities AT robertominici intravascularultrasoundfindingsinacuteandchronicdeepveinthrombosisofthelowerextremities AT antoniobasile intravascularultrasoundfindingsinacuteandchronicdeepveinthrombosisofthelowerextremities AT annamariaierardi intravascularultrasoundfindingsinacuteandchronicdeepveinthrombosisofthelowerextremities AT paolomarra intravascularultrasoundfindingsinacuteandchronicdeepveinthrombosisofthelowerextremities AT raffaellaniola intravascularultrasoundfindingsinacuteandchronicdeepveinthrombosisofthelowerextremities |