Pharmaco-mechanical catheter-directed thrombolysis versus recanalization and stenting for post thrombotic syndrome after lower limb deep vein thrombosis: a comparative study

Quantitative Imaging in Medicine and Surgery

article

Giovanni Gautier¹  Frederic Douane³  Arthur David³  Christophe Perret³  Marc-Antoine Pistorius¹  Yann Goueffic⁴  Jerôme Connault¹  Mathieu Artifoni¹  Cecile Durant¹  Gaëtan Ploton¹  Alizee Raimbeau¹  Guillaume Bergere¹  Olivier Robin¹  Blandine Maurel⁵  Olivier Espitia¹ 

[1] Department of Internal and Vascular Medicine;Department of Cardiology, Centre Hospitalier de Châteaubriant;Department of Radiology;Department of Vascular and Endovascular Surgery , Groupe Hospitalier St. Joseph;Department of Vascular Surgery;Université de Nantes

关键词: Deep vein thrombosis (DVT);    post-thrombotic syndrome (PTS);    Villalta score;    pharmaco-mechanical catheter-directed thrombolysis (PMT);    venous angioplasty and stenting;   

DOI  :  10.21037/qims-21-572

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: Endovenous interventional procedures can be used in addition to therapeutic anticoagulation to treat deep vein thrombosis in selected patients with proximal vein involvement (vena cava, iliac and/or common femoral). The aim of this study was to compare venous patency and the post-thrombotic syndrome (PTS) in patients treated with pharmaco-mechanical catheter-directed thrombolysis (PMT) versus recanalization-stenting for PTS after a proximal lower limb deep vein thrombosis. Methods: Between January 2014 and December 2020, this retrospective and monocentric study included patients with very symptomatic acute iliofemoral deep vein thrombosis treated with PMT within 21 days after diagnosis (PMT group) and patients with PTS caused by chronic venous obstruction treated with recanalization and stenting (CRS group). Results: 0.99). The rate of venous patency at the last follow-up was 76.9% (20/26) in the PMT group and 82.2% (74/90) in the CRS group (P=0.57). The median number of stents was 2 (range, 0–5) in the PMT group and 3 (range, 0–7) in the CRS group (P<0.001). The median stent length was 150 mm (range, 60–390 mm) and 280 mm (range, 120–820 mm), respectively (P<0.001). The median last Villalta score was 2 (range, 0–10) in the PMT group and 2 (range, 0–21) in the CRS group (P=0.55). The rate of venous claudication at the last follow-up was 19.0% (4/21) in the PMT group and 12.0% (10/83) in the CRS group (P=0.47). Conclusions: In this study, there was no difference in venous patency and in the rate and severity of PTS between the PMT and CRS groups. The number of stent and their length were significantly lower in the PMT group compared with the CRS group.

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