Endovascular Interventions for Lower Extremity Deep Venous Disease

A comprehensive review of the state of the art in the endovascular management of lower extremity deep venous disease.

Course ID: Q00466 Category:
Modalities: ,


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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Registered Radiologist Assistant: 2.50
Patient Care: 0.50
Pharmacology: 0.50
Procedures: 2.00
Neurological, Vascular, and Lymphatic Sections: 2.00

Vascular-Interventional Radiography: 2.50
Patient Care: 0.50
Patient Interactions and Management: 0.50
Procedures: 2.00
Vascular Interventional Procedures: 2.00


  1. Introduction
  2. Part 1: Acute Lower Extremity Deep Vein Thrombosis
    1. Epidemiology
    2. Beyond Pulmonary Embolism: Postthrombotic Syndrome
    3. Risk Factors for Developing PTS after DVT
    4. Noninterventional Methods to Prevent PTS
    5. Beyond Anticoagulation: The ìOpen Veinî Hypothesis and Lessons Learned from Systemic Thrombolysis for DVT
    6. Image-Guided Endovascular Thrombus Removal: Description and Evolution of Techniques
    7. Patient Selection for Catheter-directed Therapy: Anatomic and Clinical Considerations
    8. The Role of Imaging in Stratifying Patients and Planning for Potential Intervention
    9. Outcomes of Interventional DVT Therapy
  3. Part 2: Interventional Management of Chronic Lower Extremity Deep Venous Disease
    1. Background
    2. Patient Assessment
    3. Noninterventional Management
    4. Imaging Assessment
    5. Patient Selection and Preparation
    6. Interventional Treatment of Iliocaval Stenoses and Occlusions
    7. Complications
    8. Postprocedural Management
    9. Outcomes
  4. Conclusion


Upon completion of this course, students will:

  1. state the prevalence of lower extremity deep venous disease
  2. discuss the most feared consequence of deep venous thrombosis
  3. list three parenteral anticoagulation drugs
  4. list the symptoms of post-thrombotic syndrome
  5. recall outcomes from the Venous Thrombosis Outcomes (VETO) study
  6. explain pathogenesis of post-thrombotic syndrome
  7. recall complications from reflux and or obstruction of the venous system
  8. list patient types that have relatively minor risk of post-thrombotic syndrome
  9. explain what types of DVT increase risk of post-thrombotic syndrome
  10. identify medical trials associated with treating post-thrombotic syndrome
  11. state how VTE is associated with post-thrombotic syndrome
  12. recall the first endovascular thrombolytic method for DVT
  13. list alternate access points for when the popliteal vein is occluded
  14. list the lytic drugs currently used in clinical practice for CDT procedures
  15. state the typical infusion time period for catheter-directed thrombolysis
  16. identify the imaging modality utilized before, during, and after lytic therapy
  17. list treatments for post-thrombectomy obstructive lesions
  18. list the potential disadvantages of percutaneous mechanical thrombectomy
  19. name the components of pharmacomechanical catheter-directed thrombolysis
  20. list the general categories for PCDT technique
  21. discuss the groups of clinical severity for DVT
  22. describe patients suitable for aggressive therapy to prevent PTS
  23. review imaging modalities to determine highest sensitivity and specificity for detection of infrainguinal deep venous thrombosis
  24. state the imaging modalities used for evaluating difficult patients with DVT
  25. review limitations of multiple interventional DVT studies
  26. recall what catheter-directed thrombolysis trial was sponsored by the National Heart, Lung, and Blood Institute
  27. know the annual cost associated with venous ulcers in the United States
  28. state how chronic venous disease develops
  29. review statistics related to chronic lower extremity disease and PTS
  30. explain the importance of documentation criteria for chronic lower extremity deep venous disease
  31. list non-interventional options for DVT treatment
  32. name the indications for imaging the deep venous system in chronic venous disease
  33. indicate the use of computed tomography for imaging IVC filters
  34. state the routes of entry into the venous system
  35. document patient positioning for accessing the popliteal vein
  36. list the types of iliocaval obstructions
  37. describe findings from the PREPIC trial
  38. identify the best imaging modality for detection of luminal narrowing
  39. state the most common complication associated with interventional treatment of venous disease
  40. state the duration of anticoagulation therapy for non-thrombotic disease