Related Experiment Video
Updated: Feb 28, 2026
An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug
Published on: June 4, 2021
Comparison of Direct Iliofemoral Stenting Following AngioJet Rheolytic Thrombectomy vs Staged Stenting After AngioJet
Guang Liu1,2,3,4, Jinbao Qin1,2,3,4, Chaoyi Cui1,2,3,4
11 Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Insights
Direct stenting after AngioJet thrombectomy offers faster recovery for acute deep vein thrombosis (DVT) patients. However, staged stenting may reduce the risk of post-thrombotic syndrome (PTS) at one year.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiovascular Medicine
Background:
- Acute proximal deep vein thrombosis (DVT) with iliofemoral stenosis presents a significant clinical challenge.
- Treatment strategies aim to restore venous patency and prevent long-term complications like post-thrombotic syndrome (PTS).
- AngioJet rheolytic thrombectomy combined with stenting is a key intervention for these complex cases.
Purpose of the Study:
- To compare treatment outcomes of direct stenting versus staged stenting following AngioJet thrombectomy in patients with acute proximal DVT and iliofemoral stenosis.
- To evaluate technical success, clinical improvement, hospital stay duration, thrombolysis efficacy, and long-term patency and PTS risk.
Main Methods:
- A prospective study involving 91 patients with duplex-verified iliofemoral stenosis and acute proximal DVT.
- Patients were randomized to either direct stenting (n=46) or staged stenting with catheter-directed thrombolysis (n=45) after AngioJet thrombectomy.
- Outcomes assessed included Venous Registry Index (VRI) for patency, Villalta scale for PTS, and 1-year duplex ultrasound follow-up.
Main Results:
- Both techniques achieved 100% technical success with no 30-day mortality.
- Direct stenting showed significantly higher immediate clinical improvement (91% vs 73%) and shorter hospital stays (4.59 vs 5.8 days).
- While direct stenting had lower thrombolysis rates and higher PTS risk at 1 year, primary patency rates were similar (93.5% vs 97.8%).
Conclusions:
- Both direct and staged stenting are effective for acute proximal DVT with iliofemoral stenosis.
- Direct stenting offers faster recovery and shorter hospital stays but may be associated with a higher risk of PTS.
- Staged stenting demonstrates better outcomes regarding PTS risk at one year, despite longer hospitalizations.
Purpose:
To compare the treatment outcomes in patients with acute proximal deep vein thrombosis (DVT) and iliofemoral stenosis who underwent either direct stenting after AngioJet rheolytic thrombectomy or staged stenting after AngioJet thrombectomy plus catheter-directed thrombolysis with urokinase.
Methods:
From June 2014 to February 2016, 91 DVT patients underwent 2 treatments for duplex-verified iliofemoral stenosis: direct stenting (n = 46; mean age 54.8 years; 32 men) or staged stenting (n = 45; mean age 56.5 years; 27 men). The degree of patency after thrombectomy or thrombolysis was evaluated using the Venous Registry Index (VRI), while the risk of postthrombotic syndrome (PTS) was evaluated according to the Villalta scale. Patients were followed with periodic duplex ultrasound scans up to 1 year.
Results:
The technical success rates were 100% in both groups; there was no 30-day mortality. Immediate (24-hour) clinical improvement was achieved in 42 (91%) of 46 direct group patients vs 33 (73%) of 45 staged group patients (p<0.001). A significant reduction (p<0.001) in the length of hospital stay was noted in the direct group (4.59±0.91) compared with that in the staged group (5.8±1.6). The stents used in the direct group were longer but with similar diameter compared with the staged group. The thrombolysis rates were 81.50%±5.76% in the direct group and 85.67%±3.84% in the staged group (p<0.001). The VRIs declined (improved) significantly in both groups (11.68±1.92 to 3.21±1.44 in the direct group and 12.17±2.29 to 2.36±1.19 in the staged group, both p<0.001). The Villalta scores were significantly better in the staged group (p<0.001). Recurrent DVT occurred in 2 patients in the direct group. The primary patency rates at 1 year were 93.5% in the direct group and 97.8% in the staged group (p=0.323).
Conclusion:
Both direct and staged stenting are effective treatment modalities for patients with acute proximal DVT. Compared with staged stenting, direct stenting provides similar treatment success and a significant reduction in the length of hospital stay; however, it has lower thrombolysis efficacy, and the risk of PTS at 1 year is greater with direct stenting.
More Related Videos
13:48Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
Published on: April 21, 2023
06:59Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
Published on: August 26, 2025
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care