Ep. 594 How New Guidelines are Shaping Acute DVT Management with Dr. Steven Abramowitz

Are you up to date with the latest guidelines on deep venous thrombosis (DVT) management? Dr. Steven Abramowitz, vascular surgeon at MedStar Health, joins host Dr. Chris Beck for a deep dive into emerging clinical data in DVT management, where they review the evolving indications for mechanical thrombectomy and the implications of studies like the ATTRACT trial, the CLOUT registry, and the ongoing DEFIANCE trial. --- This podcast is supported by: Inari Medicalhttps://www.inarimedical.com/artix-system --- SYNPOSIS Dr. Abramowitz reviews recent data comparing outcomes of mechanical intervention versus lytic-based therapy, outlining how each approach fits into current practice. He underscores the critical role of IVUS in determining treatment endpoints, while noting the ongoing challenge of an absent standardized definition. The conversation also offers practical insights on procedural techniques and the evolving role of anticoagulation, emphasizing the importance of close collaboration and open communication with referring physicians. --- TIMESTAMPS 00:00 - Introduction00:45 - Overview of DVT Management02:50 - New Guidelines for DVT Treatment07:30 - Technical Endpoints in DVT Treatment13:26 - Clout Registry and Its Findings17:57 - Anticoagulation and DVT23:05 - Defining Acute DVT Management27:00 - Evolving Approaches to Acute DVT28:19 - Patient Experience and Quality of Life31:08 - Referring Providers and Data Impact37:01 - Single Session Treatments and Stenting41:07 - Chronic Venous Disease Management --- RESOURCES (ATTRACT) Weinberg I, Vedantham S, Salter A, et al. Relationships between the use of pharmacomechanical catheter-directed thrombolysis, sonographic findings, and clinical outcomes in patients with acute proximal DVT: Results from the ATTRACT Multicenter Randomized Trial. Vasc Med. 2019;24(5):442-451. doi:10.1177/1358863X19862043https://pubmed.ncbi.nlm.nih.gov/31354089/ (CLOUT) Shaikh A, Zybulewski A, Paulisin J, et al. Six-Month Outcomes of Mechanical Thrombectomy for Treating Deep Vein Thrombosis: Analysis from the 500-Patient CLOUT Registry. Cardiovasc Intervent Radiol. 2023;46(11):1571-1580. doi:10.1007/s00270-023-03509-8https://pubmed.ncbi.nlm.nih.gov/37580422/ (DEFIANCE) Abramowitz SD, Marko X, D'Souza D, et al. Rationale and design of the DEFIANCE study: A randomized controlled trial of mechanical thrombectomy versus anticoagulation alone for iliofemoral deep vein thrombosis. Am Heart J. 2025;281:92-102. doi:10.1016/j.ahj.2024.10.016https://pubmed.ncbi.nlm.nih.gov/39491572/