Interventional Treatment of Pediatric Venous Thromboembolic Disease

Tech Vasc Interv Radiol. 2024 Jun;27(2):100957. doi: 10.1016/j.tvir.2024.100957. Epub 2024 Jun 14.

Abstract

This review explores the clinical presentation of lower extremity DVT and pulmonary embolism (PE), treatment strategies, and outcomes for venous thromboembolism (VTE) in the pediatric population. Traditional therapy for pediatric VTE was anticoagulation alone with thrombolysis and surgery reserved only in life or limb-threatening cases. Catheter-directed thrombolysis (CDT), pharmacomechanical thrombectomy (PMT) and mechanical thrombectomy (MT) have emerged as effective and safe treatment options for VTE management. Although most data are from adult studies, early pediatric studies suggest that these interventional procedures can be effective in children. The significant clinical impact of post-thrombotic syndrome (PTS) is also discussed, as PTS can lead to lifelong physical symptoms and psychosocial damage.

Keywords: catheter directed thrombolysis; deep vein thrombosis; mechanical thrombectomy; pediatric pulmonary embolism; pharmacomechanical thrombolysis.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Age Factors
  • Anticoagulants / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Fibrinolytic Agents / administration & dosage
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Postthrombotic Syndrome / diagnostic imaging
  • Postthrombotic Syndrome / therapy
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / therapy
  • Radiography, Interventional
  • Risk Factors
  • Thrombectomy* / adverse effects
  • Thrombolytic Therapy* / adverse effects
  • Treatment Outcome
  • Venous Thromboembolism* / diagnostic imaging
  • Venous Thromboembolism* / therapy
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / therapy

Substances

  • Fibrinolytic Agents
  • Anticoagulants