Antithrombotic Therapy After Venous Interventions: AJR Expert Panel Narrative Review.

Area of Science:

• Vascular Medicine
• Interventional Cardiology
• Hematology

Background:

• Technical advances have increased venous interventions for thrombotic and nonthrombotic disorders.
• Antithrombotic therapy is crucial for procedural success, but regimens vary due to limited data.
• Understanding factors influencing long-term venous stent patency is incomplete.

Purpose of the Study:

• To review current antithrombotic therapy strategies for post-venous intervention care.
• To identify gaps in knowledge regarding optimal antithrombotic regimens.
• To highlight the need for standardized guidelines and further research.

Main Methods:

• Review of existing literature and guidelines on antithrombotic therapy for venous disorders.
• Analysis of current practices for both thrombotic and nonthrombotic venous conditions.
• Discussion of evidence for antiplatelet agents and multi-agent therapies.

Main Results:

• For thrombotic disorders, 3-6 months of anticoagulation is recommended, with extended therapy for high-risk patients.
• The benefit of antiplatelet agents for long-term stent patency is uncertain, though some studies suggest improvement.
• Therapy for nonthrombotic disorders is heterogeneous; specific patient groups may benefit from antithrombotics, but optimal choices are unclear.

Conclusions:

• Standardized post-interventional antithrombotic therapy is needed, particularly for nonthrombotic venous disorders.
• Prospective studies are essential to guide risk stratification and treatment protocols.
• Optimizing antithrombotic strategies will improve long-term venous intervention outcomes.