Medical and surgical management of deep vein thrombosis of the lower limbs in the acute phase

Acute deep vein thrombosis (aDVT) of the lower limbs presents a risk of complications by extension, pulmonary embolism, recurrence and long-term post-thrombotic syndrome. Medical treatment by anticoagulation and elastic venous compression reduces the risk of occurrence of the first 3 elements but does not eliminate the clot obstructing the veins. Despite everything, it remains the reference treatment for the majority of aDVT. Thrombus ablation techniques have been known for a long time. Initially surgical, the current technique of thrombectomy is essentially performed by the percutaneous endovascular route, associated or not with in situ thrombolysis. These techniques are since the recommendations of the European Society of Vascular and Endovascular Surgery of 2021 recommended (class IIa, level A) for femoro-iliac DVT of less than 14 days in selected patients. However, their use is not recommended for femoro-popliteal DVT (class III, level B).