Venous Thrombolysis: Current Perspectives.

Venous thromboembolism is a common problem in hospital and community patients and is associated with longer hospital stays, significant morbidity, and mortality. It is the third most common cardiovascular disease after ischemic coronary artery disease and stroke. A quarter of patients with acute myocardial infarction and more than half of patients with acute ischemic stroke may develop venous thromboembolism. The traditional treatment of venous thrombosis has been with anticoagulation, initially with heparin, followed by warfarin long term. The concept of thrombolysis for venous thrombosis is relatively new, but its exact role remains unsettled and largely unexplored. Reports of catheter fragmentation with systemic thrombolysis as well as catheter-directed thrombolysis are promising, and groups of patients who would benefit from thrombolytic therapy as the primary treatment are now being identified.