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Editor's Choice - Factors Associated with Long-Term Outcome in 191 Patients with Ilio-Femoral DVT Treated With

P Foegh1, L P Jensen2, L Klitfod1

  • 1Vascular Clinic, Gentofte Hospital and Rigshospitalet, University of Copenhagen, Denmark.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|January 31, 2017
PubMed

Insights

Catheter-directed thrombolysis (CDT) for ilio-femoral deep venous thrombosis (DVT) shows long-term success. Shorter symptom duration and the pulse-spray technique improve outcomes, while chronic lesions predict poorer results.

Area of Science:

  • Vascular Medicine
  • Interventional Radiology
  • Thrombosis Research

Background:

  • Acute deep venous thrombosis (DVT) of the ilio-femoral vein can lead to chronic complications.
  • Catheter-directed thrombolysis (CDT) is a treatment option for extensive DVTs.
  • Identifying factors for long-term success after CDT is crucial for patient management.

Purpose of the Study:

  • To determine predictors of long-term treatment success following catheter-directed thrombolysis (CDT) for acute ilio-femoral deep venous thrombosis (DVT).

Main Methods:

  • A non-randomized observational cohort study included 191 patients (203 limbs) treated with CDT between 1999 and 2013.
  • Patients with ultrasonically verified acute ilio-femoral DVT underwent CDT, with follow-up assessments for up to 14.3 years.
  • Long-term success was defined as patent deep veins without reflux on Duplex ultrasound scanning (DUS).

Main Results:

  • The cumulative rate of patent deep veins without reflux at 7 years was 79%.
  • Symptom duration longer than 2 weeks (HR 2.78) and chronic post-thrombotic lesions (HR 19.3) were associated with poorer outcomes.
  • The pulse-spray technique (HR 0.15) was significantly associated with better long-term outcomes.

Conclusions:

  • Shorter symptom duration (less than 2 weeks) is linked to better long-term outcomes after CDT for ilio-femoral DVT.
  • Absence of chronic post-thrombotic lesions and utilization of the pulse-spray technique predict successful long-term patency and valve function.
  • These findings aid in patient selection and treatment strategy optimization for ilio-femoral DVT.
Abstract

Keywords:
Catheter-directed thrombolysis (CDT)Deep venous thrombosis (DVT)Duplex ultrasound scanning (DUS)Ilio-femoral DVTPrognostic factorsPulse-spray

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