* Does not dissolve the clot



* Waits for the body's own internal mechanism to dissolve the thrombus which can take several months

* Leaves residual clot in the veins can lead to post-thrombotic syndrome (PTS)

Anticoagulation is the current front-line and standard treatment for deep vein thrombosis (DVT). Studies have consistently shown that anticoagulation prevents the propagation of the thrombus and protects against embolization.

Anticoagulation does not remove or break up the thrombus, rather it keeps it in check until the body's own internal mechanisms can dissolve the clot which, depending on the size of the thrombus, can take up to several months.

The management of DVT has been studied extensively. There are clear correlations between residual thrombus or venous occlusion and the development of long term sequelae, most frequently post-thrombotic syndrome (PTS) due to the blockage of normal blood flow.

Some facts about PTS:

* An untreated DVT can result in PTS

* Treatment with anticoagulation alone can lead to PTS

* Permanent damage can occur

* PTS can develop in up to 70% of all DVT patients in as little as two months

* Symptoms include chronic leg pain, fatigue, swelling and skin ulcers

Post-thrombotic syndrome is an under-recognized, but relatively common sequelae, or after effect, of having a lower extremity DVT if left untreated. It is likely caused by venous valvular incompetence and persistent obstruction in the vein.

Anticoagulation, or treatment with blood thinners alone, can also lead to PTS because the clot remains in the vein. Contrary to popular belief,anticoagulants do not actively dissolve the clot, they just prevent the clot from growing and greatly reduce the probability that a piece of the clot will break off and travel to the lungs (embolize). The body will eventually dissolve a clot, but often the vein becomes damaged in the meantime.

A significant proportion of these patients develop irreversible damage in the affected leg veins and their valves, resulting in abnormal pooling of blood in the leg, chronic leg pain, fatigue, swelling, and, in extreme cases, severe skin ulcers (non healing wounds).

Post-thrombotic syndrome develops in up to 50 percent of people with residual blood clot and can occur in as soon as two months. There is increasing evidence that clot removal using an endovascular approach in selected cases of DVT can not only remove the clot quickly, which will greatly reduce the chance of developing PTS, but will also improve the patient's quality of life.

Living with a deep vein thrombosis (DVT) can result in:

* Reduced ability to live a "normal" life

* Necessity of wearing elastic compression stockings

* Balancing dietary and medication interactions

* Changing of daily activities and routines

A consequence of living with a DVT is the reduction in patient quality of life (QOL). The ability to perform day to day activities are reduced. Patients must wear specialized elastic stockings, known as graduated compression stockings, monitor their diet to maintain proper concentrations of anticoagulants, and modify their daily activities.

Therefore, the goal of treating a DVT is to avoid both early and late complications of venous thrombosis including the prevention of pulmonary embolism and the restoration of blood flow with the preservation of venous valve function.

Multiple clinical studies consistently show that a strategy of early thrombus removal combined with anticoagulation therapy can result in rapid resolution of symptoms and a significant reduction in long term after effects.

The new early clot removal technique of Isolated Pharmacomechanical Thrombolysis has been shown to be safe and effective and is now recommended by the American College of Chest Physicians for the treatment of acute proximal DVT.