Long-term outcome of manual aspiration thrombectomy for acute proximal deep vein thrombosis

Manual aspiration thrombectomy (MAT) is a catheter intervention for cases with a high risk of bleeding. It is a rapid, simple, inexpensive, and single-session intervention for patients with proximal deep vein thrombosis (DVT). We evaluated the long-term outcome of MAT for patients with proximal DVT. All consecutive patients with acute proximal DVT treated at our center from April 2012 to December 2022 were retrospectively screened. Twenty-one patients who underwent MAT were enrolled. We evaluated the incidence and clinical characteristics of post-thrombotic syndrome (PTS) post-MAT in the chronic phase. The venous clot burden extent was assessed using the venographic segment (VS) score during catheter intervention. We evaluated the pre- and post-treatment total VS score. PTS was evaluated by PTS onset at any time between 6 and 24 months. We compared the clinical characteristics of patients with and without PTS (PTS and non-PTS groups, respectively). PTS onset at any time between 6 and 24 months post-MAT was 33%. The PTS group had a significantly higher post-treatment total VS score and lower thrombus aspiration success rate than the non-PTS group. Furthermore, the PTS group had a significantly longer duration from onset to intervention than the non-PTS group. PTS onset post-MAT was 33% in the chronic phase. The PTS group showed a lower thrombus aspiration success rate and longer duration from DVT onset to intervention than the non-PTS group. These findings suggest that earlier and substantial thrombus reduction with MAT may be associated with a lower risk of PTS.