Anticoagulation practices in venous occlusive disease after stent placement

Characterize physician anticoagulation practices after stent placement in patients with venous occlusive disease.

Survey-based analysis was conducted between January 2023 and April 2023 (for 109 days) evaluating practices of post venous stent placement anticoagulation regimens. A survey investigated provider demographics, agent selection, dosing, duration, and patient factors taken in agent choice. The survey was distributed through email lists and promoted on social media and limited users to one response. Questions stratified for both superior vena cava (SVC) and upper extremity and inferior vena cava (IVC) and lower extremity interventions. Descriptive statistics determined the significance of the regimen utilization.

One hundred twenty-nine respondents participated in the study, with interventional radiologists constituting 94%. The preferred regimen for SVC interventions was direct oral anticoagulants (DOAC) and single antiplatelet therapy, accounting for 39/117 of respondents. For IVC interventions, low molecular weight heparin (LMWH) and single antiplatelet therapy was the regimen of choice representing 12/38 of preferences. SVC intervention therapy duration was most common to be lifetime for aspirin (10; 43%), 3 months for non-ASA antiplatelet agents (23; 52%), and 6 months for anticoagulants (32; 44%). For IVC therapies, the trend of drug duration for aspirin was most common to be lifetime (6;40%), for non-ASA antiplatelets was 3 months (10; 53%), and for anticoagulants tied for 6 and 12 months (7; 30% each). Eight risk factors affected post-intervention anticoagulation selection.

This work highlights the most common post-venous stenting anticoagulation regimens currently in clinical practice.