Percutaneous mechanical thrombectomy for acute deep vein thrombosis of the leg

Current evidence on the safety of percutaneous mechanical thrombectomy for acute deep vein thrombosis (DVT) of the leg shows there are well-recognised but infrequent complications.

• For acute iliofemoral DVT, the evidence on efficacy is limited in quality and quantity, therefore this procedure should only be used with special arrangements for clinical governance, consent, and audit or research. Find out what special arrangements mean on the NICE interventional procedures guidance page.

• For distal DVT that does not extend into the common femoral vein, the evidence on efficacy is inconclusive, therefore this procedure should only be used in the context of research. Find out what only in research means on the NICE interventional procedures guidance page.

Clinicians wishing to do percutaneous mechanical thrombectomy for acute iliofemoral DVT should:

• Inform the clinical governance leads in their NHS trusts.

• Ensure that patients understand the procedure's safety and efficacy, as well as any uncertainties about these. Provide them with clear written information to support shared decision making. In addition, the use of NICE's information for the public is recommended.

Clinicians should enter details of all patients who have the procedure onto the British Society of Interventional Radiology Venous Registry.

Further research should report the patient selection criteria including the site of the clot, symptom severity and age of patients.