TY - JOUR
T1 - ACR Appropriateness Criteria® Radiologic Management of Iliofemoral Venous Thrombosis
AU - Expert Panel on Interventional Radiology
AU - Farsad, Khashayar
AU - Kapoor, Baljendra S.
AU - Fidelman, Nicholas
AU - Cain, Thomas R.
AU - Caplin, Drew M.
AU - Eldrup-Jorgensen, Jens
AU - Gupta, Amit
AU - Higgins, Mikhail
AU - Hohenwalter, Eric J.
AU - Lee, Margaret H.
AU - McBride, Joseph J.
AU - Minocha, Jeet
AU - Rochon, Paul J.
AU - Sutphin, Patrick D.
AU - Lorenz, Jonathan M.
N1 - Funding Information:
Dr Farsad reports other from Auxetics, Inc, personal fees from Cook Medical, personal fees from BTG, personal fees from Neuwave, grants and personal fees from Guerbet, LLC, personal fees from Genentech, personal fees from Dova Pharmaceuticals, outside the submitted work; In addition, Dr Farsad has a patent ?use of specific stent class for the management of venous stenosis? licensed to Auxetics, Inc. Dr Rochon reports support from Penumbra, support from Medtronic outside the submitted work. The other authors state that they have no conflict of interest related to the material discussed in this article.
Publisher Copyright:
© 2020 American College of Radiology
PY - 2020/5
Y1 - 2020/5
N2 - Iliofemoral venous thrombosis carries a high risk for pulmonary embolism, recurrent deep vein thrombosis, and post-thrombotic syndrome complicating 30% to 71% of those affected. The clinical scenarios in which iliofemoral venous thrombosis is managed may be diverse, presenting a challenge to identify optimum therapy tailored to each situation. Goals for management include preventing morbidity from venous occlusive disease, and morbidity and mortality from pulmonary embolism. Anticoagulation remains the standard of care for iliofemoral venous thrombosis, although a role for more aggressive therapies with catheter-based interventions or surgery exists in select circumstances. Results from recent prospective trials have improved patient selection guidelines for more aggressive therapies, and have also demonstrated a lack of efficacy for certain conservative therapies. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
AB - Iliofemoral venous thrombosis carries a high risk for pulmonary embolism, recurrent deep vein thrombosis, and post-thrombotic syndrome complicating 30% to 71% of those affected. The clinical scenarios in which iliofemoral venous thrombosis is managed may be diverse, presenting a challenge to identify optimum therapy tailored to each situation. Goals for management include preventing morbidity from venous occlusive disease, and morbidity and mortality from pulmonary embolism. Anticoagulation remains the standard of care for iliofemoral venous thrombosis, although a role for more aggressive therapies with catheter-based interventions or surgery exists in select circumstances. Results from recent prospective trials have improved patient selection guidelines for more aggressive therapies, and have also demonstrated a lack of efficacy for certain conservative therapies. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
KW - AUC
KW - Appropriate Use Criteria
KW - Appropriateness Criteria
KW - Catheter-directed therapy
KW - Deep vein thrombosis (DVT)
KW - Iliofemoral venous thrombosis
KW - Thrombolysis
KW - Venous stent
UR - http://www.scopus.com/inward/record.url?scp=85083706080&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85083706080&partnerID=8YFLogxK
U2 - 10.1016/j.jacr.2020.01.035
DO - 10.1016/j.jacr.2020.01.035
M3 - Article
C2 - 32370969
AN - SCOPUS:85083706080
VL - 17
SP - S255-S264
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
SN - 1558-349X
IS - 5
ER -