NICE has been notified about this procedure and it is part of its work programme. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
 
Status In progress
Process IP
ID number 1700
Description Percutaneous mechanical thrombectomy for acute deep vein thrombosis of the leg is usually done in conjunction with direct infusion of a thrombolytic drug into the thrombus but may also be used as a standalone therapy, if thrombolytic drugs are contraindicated. It can also be used following thrombolysis if residual thrombus persists. Before the procedure, imaging is reviewed to determine appropriate access, usually the popliteal or femoral vein. Under local anaesthetic venous access is established and a catheter is advanced into the thrombus using fluoroscopic guidance. There are a range of mechanical thrombectomy devices which use different principles. The objective is mechanical disruption and aspiration of the thrombus. A temporary inferior vena cava filter may be used during the procedure to reduce the risk of pulmonary embolism from displaced clot. Following the procedure treatment with anticoagulant drugs is usually given to prevent recurrence. Early ambulation and use of compression stockings is advised. Adjuvant angioplasty or stenting of the vein may be needed if thrombus removal unmasks an anatomical lesion that contributed to the formation of the DVT.

Provisional Schedule

Expected publication 12 June 2019

Timeline

Key events during the development of the guidance:

Date Update
24 January 2019 - 21 February 2019 Interventional procedure consultation
25 October 2018 - 22 November 2018 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance