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Prognostic factors influencing venous patency after thrombectomy in patients with May-Thurner syndrome

Chang Hoon Oh1, In Chul Nam2, Doo Ri Kim2

  • 1Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Plos One
|November 25, 2025
PubMed

Insights

Residual venous stenosis ≥50% after thrombectomy for May-Thurner syndrome (MTS) predicts poor long-term venous patency. Effective stenosis resolution, not stent placement, is key for successful outcomes in deep vein thrombosis (DVT) treatment.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • May-Thurner syndrome (MTS) is an anatomical variant predisposing to iliofemoral deep vein thrombosis (DVT).
  • Thrombectomy is a treatment option for MTS-associated DVT, but long-term patency rates vary.
  • Predictors of long-term venous patency after thrombectomy in MTS patients require further elucidation.

Purpose of the Study:

  • To assess the prognostic value of venographic findings and procedural factors for long-term venous patency.
  • To identify independent predictors of reocclusion after thrombectomy in MTS-associated DVT.
  • To evaluate the role of stent placement and diameter in maintaining venous patency.

Main Methods:

  • Retrospective cohort study of 75 patients with MTS-associated iliofemoral DVT undergoing thrombectomy.
  • Analysis of venographic findings: venous stenosis (≥50%), venous spur, persistent collaterals.
  • Assessment of 24-month venous patency using univariate and multivariate Cox proportional hazards modeling.

Main Results:

  • 58 patients (77.3%) maintained 24-month venous patency; 17 (22.7%) experienced reocclusion.
  • Univariate analysis linked stenosis ≥50%, venous spur, and absence of stent placement to reduced patency (p<0.05).
  • Multivariate analysis identified residual venous stenosis ≥50% as the sole independent predictor of reocclusion (HR=5.04, p=0.021).

Conclusions:

  • Residual venous stenosis ≥50% post-thrombectomy is a significant independent predictor of reduced long-term venous patency in MTS patients.
  • Stent placement did not independently predict patency in multivariate analysis, suggesting anatomical resolution is critical.
  • Further prospective studies are needed to clarify the impact of venographic findings and interventions on DVT outcomes.
Abstract

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