Factors associated with the development of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis who underwent catheter-directed thrombolysis

Abstract

Objective To identify predictors of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis who underwent catheter-directed thrombolysis. Methods Fifty-two consecutive patients who underwent catheter-directed thrombolysis were included in this retrospective study. In addition to catheter-directed thrombolysis, aspiration thrombectomy or stent placement was performed if needed. At six months, duplex ultrasound was performed to assess iliofemoral patency and deep venous reflux. Post-thrombotic syndrome was assessed using the clinical, etiologic, anatomic, and pathophysiologic classification (post-thrombotic syndrome present ≥3 on a scale from 0 to 6). Univariate analysis and multivariate logistic regression were used to identify predictors of post-thrombotic syndrome. Results Median follow-up was 52 months and post-thrombotic syndrome developed in nine patients (17.3%). In univariate analysis, stent placement (odds ratio 0.16, p = 0.022) was negatively associated with post-thrombotic syndrome, whereas iliofemoral venous obstruction with reflux at six months (OR 6.08, p = 0.037) was positively associated with post-thrombotic syndrome. Multivariate analysis indicated that stent placement was associated with reduced risk of post-thrombotic syndrome (OR 0.17, p = 0.043), and iliofemoral obstruction with reflux was associated with increased risk (OR 6.67, p = 0.046). Conclusion Stent placement and iliofemoral venous obstruction with reflux, respectively, were important protective and risk factors for post-thrombotic syndrome in patients who underwent catheter-directed thrombolysis.

Catheter-Directed Thrombolysis Protocols for Deep Venous Thrombosis of the Lower Extremities—A Systematic Review and Meta-analysis

“…The search yielded 4,168 references and 46 met the eligibility criteria for inclusion in this review 5 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 reporting 49 CDT protocols ( Fig. 1 ).…”

Feasibility of Anticoagulation Using Low Molecular‑Weight Heparin During Catheter-Directed Thrombolysis for Lower Extremity Deep Venous Thrombosis

“…In addition, a relatively low rate of adjunctive strategies, including balloons, stents, and percutanous mechanical thrombectomy, was applied, which might underestimate the thrombolytic result. 21,22 In a meta-analysis involving 45 studies, major bleeding occurred in 196 (7.9%) of 2467 patients experiencing CDT, and 18 (0.8%) of 2388 patients underwent CDT developed intracranial bleeding. 23 No major bleeding or intracranial bleeding was identi ed in the present study.…”

Feasibility of Anticoagulation using Low Molecular‑weight Heparin during Catheter-directed Thrombolysis for Lower Extremity Deep Venous Thrombosis

“…In addition, a relative low rate of adjunctive strategies, including balloon, stent and percutanous mechanical thrombectomy, was applied, which might affect the thrombolytic result. 18,19 In a meta-analysis involving 45 studies, major bleeding occurred in 196 (7.9%) of 2467 patients experiencing CDT, and 18 (0.8%) of 2388 patients underwent CDT developed intracranial bleeding. 20 No major bleeding or intracranial bleeding was identi ed in the present study.…”