Venous function assessed during a 5 year period after acute ilio-femoral venous thrombosis treated with anticoagulation

CIRSE Standards of Practice Guidelines on Iliocaval Stenting

“…The role of venous obstruction is increasingly recognized as a major cause of CVD, with obstructive lesions in the iliocaval segment being markedly more relevant than lesions at the levels of the crural and femoral veins [4][5][6][7][8]. Iliac vein obstruction is most commonly due to insufficient recanalization following an episode of acute deep venous thrombosis (DVT), with approximately 70-80 % of veins developing a variable degree of obstruction [4,9]. Nonthrombotic iliac vein obstruction occurs where it is crossed by the iliac or hypogastric artery a condition known as May-Thurner or Cockett's syndrome [5].…”

Endovascular treatment of iliofemoral deep vein thrombosis in pregnancy using US-guided percutaneous aspiration thrombectomy

“…Lysis did not occur in 82% of patients who either failed to improve or worsened. Persistence of thrombus in the deep veins leads to venous outflow obstruction and valvular incompetence, which is ultimately the cause of PTS in most patients (4)(5)(6)(7)(8). Data from the National Venous Thrombolysis Registry, strongly point to a relationship between the degree of lysis and venous valvular function; 62% of patients with <50% lysis had valvular incompetence, whereas 72% of patients who had complete lysis had normal valve function (15).…”

“…Data from the National Venous Thrombolysis Registry, strongly point to a relationship between the degree of lysis and venous valvular function; 62% of patients with <50% lysis had valvular incompetence, whereas 72% of patients who had complete lysis had normal valve function (15). Patients who progress to PTS could have a poor quality of life and disability due to clinical features of post-thrombotic sequelae including lifestyle-limiting chronic leg pain and edema, heaviness, and/or fatigue, and in severely affected patients venous claudication, varicosities, stasis dermatitis, hyperpigmentation and subsequently venous stasis ulcers (4)(5)(6)(7)(8).…”

“…A preponderance of the evidence in patients with lower extremity DVT suggests a strategy of early thrombus elimination for fast symptom relief and restoration of venous patency to protect valve function and prevent development of the PTS (4)(5)(6)(7)(8)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Alternative treatment options have been used to remove thrombus from deep veins because of the disappointing results with anticoagulation therapy (16)(17)(18).…”

“…Persistence of thrombus within deep veins leads to venous hypertension, which is ultimately the cause of post-thrombotic syndrome (PTS) and late disability in 20% to 50% of patients. PTS is a conglomerate of lifestyle-limiting symptoms that commonly includes chronic leg pain and swelling, heaviness, and/or fatigue, venous claudication, stasis dermatitis, and in advanced cases skin ulcerations due to valvular incompetence accompanied by persistent venous outflow obstruction (4)(5)(6)(7)(8). Pregnant women are generally younger than other women in the general population, and they likely suffer a more severe form of PTS for a much longer time.…”