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Assessing outcomes after thrombectomy with or without iliac vein stenting for young provoked DVT patients with iliac

Hongji Pu1,2, Jumin Song3, Zhijun He4

  • 1Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Rd, Shanghai, 200011, P. R. China.

Thrombosis Journal
|September 15, 2023
PubMed

Insights

Thrombectomy with iliac vein stenting showed better short-term outcomes for young deep vein thrombosis (DVT) patients with iliac vein stenosis. However, long-term efficacy and quality of life were similar to thrombectomy alone.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Iliac vein stenosis is a significant cause of deep vein thrombosis (DVT) in young adults.
  • Transiently provoked DVT in young patients presents unique management challenges.
  • Assessing the role of thrombectomy with or without stenting is crucial for optimizing outcomes.

Purpose of the Study:

  • To evaluate the effectiveness of thrombectomy with iliac vein stenting versus thrombectomy alone.
  • To compare clinical outcomes, including symptom severity and quality of life, in young DVT patients.
  • To identify the optimal interventional strategy for iliac vein stenosis in this demographic.

Main Methods:

  • Retrospective analysis of a prospectively collected multicenter database.
  • Inclusion of acute, transiently provoked DVT patients aged 18-45 with iliac vein stenosis.
  • Comparison of outcomes between thrombectomy alone (nonstenting) and thrombectomy with stenting groups.

Main Results:

  • The stenting group demonstrated significantly lower Villalta scores at 6 months (0.73 vs. 1.41, p=0.0004).
  • The stenting group showed a trend towards higher VEINES-QOL scores at 6 months (89.00 vs. 87.47, p=0.2141).
  • No significant differences in Villalta or VEINES-QOL scores were observed between groups at 12 months or beyond.

Conclusions:

  • Thrombectomy with iliac vein stenting offers superior short-term efficacy in reducing DVT symptoms and improving quality of life.
  • Long-term outcomes, including symptom burden and quality of life, are comparable between stenting and non-stenting groups up to 2 years.
  • The findings suggest that while stenting provides initial benefit, its long-term advantage may diminish over time.
Abstract

Keywords:
Deep venous thrombosisIliac vein stenosisThrombectomyVenous stents

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