Medscape has posted some presentations from the 36th Annual VEITH Symposium. This one
makes a strong pitch for catheter based and surgical treatments in patients who have extensive (iliofemoral) DVT. Although the speakers appealed to the ACCP guidelines their statement was somewhat stronger than the guideline recommendation, which suggests that in patients with extensive DVT, an anticipated survival of over a year and low bleeding risk such treatments may be used to reduce acute symptoms and post thrombotic syndrome if appropriate expertise is available.
On a related note, do the guidelines recommend catheter directed or surgical treatments for upper extremity DVT? Not across the board, but if there are severe symptoms of recent onset and low bleeding risk they make similar recommendations to those for lower extremity DVT.