Local and systemic thrombolytic therapy for acute venous thromboembolism

Venous thromboembolism (VTE) results in significant morbidity and mortality. Although anticoagulation is considered the standard of care, thrombolytic therapy, with its ability to produce rapid and more complete clot lysis, has long been considered an attractive option to prevent the short- and long-term adverse outcomes of VTE. Despite widespread interest in the use of thrombolysis for VTE and studies performed over more than 3 decades, the appropriate indications for thrombolytic therapy remain debatable. This article provides a comprehensive review of the literature evaluating the efficacy and safety of thrombolytic therapy in VTE and offers evidence-based recommendations for its use.