Catheterdirected

Catheter-directed, sometimes written catheterdirected, is a term used in interventional medicine to describe procedures in which therapy is delivered through a catheter directly to a target tissue or vessel, enabling localized treatment with reduced systemic exposure. It encompasses catheter-directed thrombolysis, local infusion of drugs such as anticoagulants or chemotherapeutics, and mechanical approaches like thrombectomy and embolization.

Common indications include acute limb ischemia and deep vein thrombosis, pulmonary embolism, stroke in appropriately selected patients, and liver-directed therapies for tumors, such as hepatic arterial infusion and chemoembolization. The approach is chosen to maximize local efficacy while limiting systemic exposure and bleeding risk.

Technique involves vascular access via arterial or venous routes under imaging guidance, placement of microcatheters, and delivery of therapy through controlled infusion pumps or during mechanical aspiration. Real-time imaging and angiography are used to monitor perfusion and vessel patency. Procedures may be combined with systemic therapy within a multidisciplinary care plan.

Benefits of catheter-directed therapy include higher local drug concentrations, targeted reperfusion, potentially lower systemic side effects, and faster restoration of perfusion in selected cases. It can facilitate tissue salvage and may avoid more invasive surgery in certain settings.

Risks and limitations include bleeding, vessel injury or dissection, catheter-related infection, and procedure-related complications. Outcomes vary by indication, patient factors, and institutional expertise, and the approach requires specialized equipment and teams.