American College of Radiology
ACR Appropriateness Criteria®

Radiologic Management of Iliofemoral Venous Thrombosis

Variant 1: First episode of iliofemoral DVT. Symptoms present for <14 days, otherwise healthy.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
Anticoagulation alone May be appropriate N/A N/A 5 n/a 0 0 0 0 0 0 0 0 0
Catheter directed thrombolysis (CDT) Usually appropriate N/A N/A 8 n/a 0 0 0 0 0 0 0 0 0
Surgical thrombectomy Usually not appropriate N/A N/A 3 n/a 0 0 0 0 0 0 0 0 0
Variant 2: Iliofemoral DVT and symptoms ≤10 days. Computed tomography scan demonstrates potential for May-Thurner syndrome.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
Anticoagulation alone Usually not appropriate N/A N/A 3 n/a 0 0 0 0 0 0 0 0 0
Catheter directed thrombolysis (CDT) with evaluation and potential stent placement Usually appropriate N/A N/A 8 n/a 0 0 0 0 0 0 0 0 0
Surgical thrombectomy and repair of iliac vein Usually not appropriate N/A N/A 2 n/a 0 0 0 0 0 0 0 0 0
Variant 3: Iliofemoral DVT and limb-threatening ischemia (phlegmasia cerulea dolens).
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
Anticoagulation alone Usually not appropriate N/A N/A 3 n/a 0 0 0 0 0 0 0 0 0
Catheter directed thrombolysis (CDT) Usually appropriate N/A N/A 8 n/a 0 0 0 0 0 0 0 0 0
Surgical thrombectomy May be appropriate N/A N/A 6 n/a 0 0 0 0 0 0 0 0 0
Variant 4: Iliofemoral DVT with minimal symptoms. DVT diagnosed one week ago.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
Anticoagulation alone Usually appropriate N/A N/A 7 n/a 0 0 0 0 0 0 0 0 0
Catheter directed thrombolysis (CDT) Usually appropriate N/A N/A 7 n/a 0 0 0 0 0 0 0 0 0
Surgical thrombectomy Usually not appropriate N/A N/A 2 n/a 0 0 0 0 0 0 0 0 0
Systemic thrombolysis Usually not appropriate N/A N/A 2 n/a 0 0 0 0 0 0 0 0 0
Please refer to the supporting documentation for a more complete discussion of the concepts and their definitions below.
Final Tabulations:
A histogram of the number of panel members who rated the recommendation as noted in the column heading (ie, 1, 2, 3, …etc.)
Disagree:
The variation of the individual ratings from the median rating indicates panel disagreement on the final recommendation.
References:
Lists the references associated with the recommendation
SQ:
Study Quality (1, 2, 3, 4, Good M or Inadequate M) of the references listed.
RRL:
Information on the Relative Radiation Level (RRL) designations can be found here.