Short- and Mid-Term Outcomes of Endovascular Stenting for the Treatment of Post-Thrombotic Syndrome due to Iliofemoral and Caval Occlusive Disease: A Multi-Centric Study from the French Society of Diagnostic and Interventional Cardiovascular Imaging (SFICV)

Purpose To assess the results of endovascular treatment in a large population of patients suffering from post-thrombotic syndrome (PTS) due to iliocaval occlusive disease. Methods In this retrospective multi-center study, 698 patients treated by stenting for PTS in 15 French centers were analyzed. P...

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Published in:CardioVascular and Interventional Radiology Vol. 45; no. 2; pp. 162 - 171
Main Authors: David, Arthur, Thony, Frédéric, del Giudice, Costantino, Goyault, Gilles, Loffroy, Romaric, Guillen, Kévin, Le Bras, Yann, Marcelin, Clément, Monnin-Bares, Valérie, Heautot, Jean-François, Lablee, Alexandre, Marek, Pierre, Rousseau, Hervé, Martinelli, Thomas, Thouveny, Francine, Barral, Pierre-Antoine, Le Pennec, Vincent, Chabrot, Pascal, Rogopoulos, André, Guillien, Alicia, Sapoval, Marc, Rodière, Matthieu, Espitia, Olivier, Douane, Frédéric
Format: Journal Article
Language:English
Published: New York Springer Science and Business Media LLC 01.02.2022
Springer US
Springer Nature B.V
Cardiovascular and Interventional Radiological Society of Europe (CIRSE)
Subjects:
[PHYS.PHYS.PHYS-BIO-PH] Physics [physics]/Physics [physics]/Biological Physics [physics.bio-ph]
Anticoagulants
Biological Physics
Cardiology
Cardiovascular system
Catheters
Clinical Investigation
Computed tomography
Data collection
Endovascular Procedures
Femoral Vein
Hospitals
Humans
Iliac Vein
Imaging
Implants
Leg ulcers
Medical diagnosis
Medicine
Medicine & Public Health
Morbidity
Nuclear Medicine
Occlusion
Patients
Physics
Postthrombotic Syndrome
Postthrombotic Syndrome - diagnostic imaging
Quality of life
Questionnaires
Radiology
Retrospective Studies
Stents
Success
Surgery
Thrombosis
Treatment Outcome
Ultrasound
Vascular Patency
Veins & arteries
Venous Interventions
Postthrombotic syndrome
Stenting
Endovascular procedures
Vascular patency
ISSN:0174-1551, 1432-086X, 1432-086X
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Summary:Purpose To assess the results of endovascular treatment in a large population of patients suffering from post-thrombotic syndrome (PTS) due to iliocaval occlusive disease. Methods In this retrospective multi-center study, 698 patients treated by stenting for PTS in 15 French centers were analyzed. Primary, primary assisted, and secondary patency rates were assessed, and clinical efficacy was evaluated using Villalta and Chronic Venous Insufficiency Questionnaire in 20 questions (CIVIQ-20) scores. Outcomes were compared against pre-operative CT-based severity of the post-thrombotic lesions in the thigh (4 grades). Results Technical success, defined as successful recanalization and stent deployment restoring rapid anterograde flow in the targeted vessel, was obtained in 668 (95.7%) patients with a complication rate of 3.9%. After a mean follow-up of 21.0 months, primary patency, primary assisted patency, and secondary patency were achieved in 537 (80.4%), 566 (84.7%), and 616 (92.2%) of the 668 patients, respectively. Venous patency was strongly correlated to the grade of post-thrombotic changes in the thigh, with secondary patency rates of 96.0%, 92.9%, 88.4%, and 78.9%, respectively, for grades 0 to 3 ( p  = .0008). The mean improvements of Villalta and CIVIQ-20 scores were 7.0 ± 4.7 points ( p  < .0001) and 19.1 ± 14.8 points ( p  < .0001), respectively. Conclusion Endovascular stenting as a treatment option for PTS due to chronic iliocaval venous occlusion generates a high technical success, low morbidity, high midterm patency rate, and clinical improvement. Venous patency was strongly correlated to the severity of post-thrombotic lesions in the thigh.
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ISSN:0174-1551
1432-086X
1432-086X
DOI:10.1007/s00270-021-03038-2