Angioplasty or stenting for deep venous thrombosis

Area of Science:

• Vascular Medicine
• Interventional Cardiology
• Medical Interventions

Background:

• Deep venous thrombosis (DVT) management typically involves anticoagulation and compression stockings.
• Angioplasty and stenting aim to restore blood flow and minimize DVT complications like post-thrombotic syndrome (PTS).
• The efficacy of angioplasty and stenting as adjunctive treatments for DVT remains under investigation.

Purpose of the Study:

• To evaluate the impact of angioplasty or stenting, alongside anticoagulation and thrombolysis, compared to best medical treatment (BMT) or thrombolysis alone.
• To assess the effects on primary outcomes including PTS and venous thromboembolism (VTE).
• To analyze secondary outcomes such as mortality, bleeding, patency, and quality of life.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs).
• Searched multiple databases (CENTRAL, MEDLINE, Embase, etc.) up to April 2023.
• Included RCTs comparing angioplasty/stenting with BMT or thrombolysis for acute DVT obstruction.

Main Results:

• Two RCTs (134 participants) were included.
• Angioplasty/stenting showed very uncertain effects on PTS and adverse events (limb pain).
• May increase secondary patency, but evidence is very uncertain; effects on quality of life are also uncertain.

Conclusions:

• While angioplasty/stenting might enhance secondary patency in acute DVT, the evidence is highly uncertain.
• Effects on PTS, quality of life, and adverse events require further investigation.
• Future trials need larger sample sizes and detailed data to clarify clinical outcomes and safety.