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Long Term Follow Up, Causes for Re-intervention, and Consequences for Surveillance After Stenting for Proximal Deep

Jay M Bakas1, Adriaan Moelker2, Catherine van Montfrans3

  • 1Department of Vascular and Endovascular Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|June 29, 2023
PubMed

Insights

Long-term deep venous stenting shows good patency for acute deep vein thrombosis (DVT) and post-thrombotic syndrome (PTS). Re-interventions, often in the first year, may be preventable with improved techniques and patient selection.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Venous stenting for acute deep vein thrombosis (DVT) and post-thrombotic syndrome (PTS) is increasingly common.
  • While short-term patency is good, long-term outcomes and re-intervention causes require further investigation.

Purpose of the Study:

  • To evaluate the long-term outcomes of venous stenting in patients with acute DVT and PTS.
  • To identify the primary causes of re-intervention following venous stenting.

Main Methods:

  • Retrospective cohort study of 114 patients (129 limbs) undergoing venous stenting between 2006 and 2021.
  • Patency assessed via duplex ultrasound or CT; re-intervention causes classified using the Pouncey system.
  • Kaplan-Meier analysis for re-intervention-free survival; logistic regression for predictor identification.

Main Results:

  • Long-term primary patency was 73.5% for acute DVT and 63.2% for PTS.
  • Secondary patency rates were high (98.1% for DVT, 92.1% for PTS).
  • Most re-interventions (82.9%) occurred within the first year, often due to missed inflow or thrombosis; inflow disease predicted re-intervention in PTS.

Conclusions:

  • Deep venous stenting demonstrates good long-term patency for DVT and PTS.
  • Re-interventions are concentrated in the first year and may be preventable through procedural refinement and patient selection.
  • Excellent secondary patency supports considering discharge from long-term surveillance for select patients.
Abstract

Keywords:
ClassificationPost-thrombotic syndromeStentsVascular patencyVenous thrombosis

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