Abstract:

In this article we primarily explored the treatment strategies for subacute lower extremity deep vein thrombosis (LEDVT). We introduced the definition, incidence, and clinical stage of DVT, emphasized the pathological changes following thrombosis and the lag in the clinical course, discussed diagnostic methods for subacute DVT, including venous ultrasound examination, super-microvascular imaging (SMI), two-dimensional shear-wave elastography（2D-SWE），and venography, highlighting the importance of these techniques in determining the property and stage of the thrombus. In terms of treatment, we underscored the fundamental role of anticoagulant therapy and mentioned the adjuvant effects of vasoactive drugs and heparinoid antithrombotic drugs. We recommended interventional thrombectomy techniques, such as catheter-directed thrombolysis (CDT), percutaneous mechanical thrombectomy (PMT), and large-bore catheter manual aspiration (MAT). In this article we cited results from multiple clinical studies, demonstrating the effectiveness and safety of these techniques in the treatment of subacute DVT. Finally, we looked forward to future research directions in the diagnosis and treatment of subacute DVT, including the development of new molecular imaging technologies, the establishment of a correlation model between the degree of thrombus organization and treatment outcomes, the exploration of the effects of anticoagulant combined with vasoactive drugs, and the use of artificial intelligence for prognosis prediction. We emphasized that with the advancement of precision medicine, the diagnosis and treatment of subacute DVT are expected to shift from an empirical model to a stratified management approach based on thrombus biological characteristics, in order to improve patients’ long-term prognosis.

Key words: Subacute lower extremity deep vein thrombosis(LEDVT), Anticoagulant therapy, Thrombectomy technique