Abstract: Deep vein thrombosis （DVT） of the lower extremity is a common and serious condition in vascular surgery, and can lead to fatal pulmonary embolism （PE） and post-thrombotic syndrome （PTS）, severely affecting quality of life. Although traditional anticoagulation therapy serves as the cornerstone, it has limited efficacy in removing established thrombi. Consequently, the incidence of PTS remains persistently high （20%‒50%）. Furthermore, for patients with extensive iliofemoral vein thrombosis （e.g., phlegmasia cerulea dolens）, anticoagulation alone is insufficient to prevent high-risk limb gangrene. Catheter-directed thrombolysis （CDT） has shown promise, but pivotal studies （e.g., the ATTRACT trial） have demonstrated that it fails to significantly reduce the incidence of long-term PTS and increases the risk of bleeding. Percutaneous mechanical thrombectomy （PMT）, as an innovative physical thrombectomy technology, has developed rapidly over the past decade. New and efficient devices have emerged and have been recommended by domestic and international guidelines. Based on the background, core advantages, and guideline positioning of PMT technology, this paper systematically reviewed the technical principles, clinical evidence, and safety characteristics of mainstream PMT devices. It analyzed the key challenges currently faced, focused on their future development prospects, and proposed directions that need to be urgently addressed, such as intelligent precision, efficiency improvement, cost control, and high-quality evidence-based research.

Key words: Deep vein thrombosis, Percutaneous mechanical thrombectomy, Catheter-directed thrombolysis