Postthrombotic Syndrome in Acute Iliofemoral Deep Vein Thrombosis

Objectives: Postthrombotic syndrome (PTS) due to chronic venous insufficiency has been shown to affect many patients with a history of proximal iliofemoral deep vein thrombosis (IF-DVT). The current treatment options include catheter-directed thrombolysis (CDT), recommended by the National Institute of Clinical Excellence, and/or alternatively percutaneous mechanical thrombectomy (PMT) to reduce the incidence of PTS and associated potential poor quality of life (QoL). We set out to identify the rate and severity of PTS and explore the QoL among IF-DVT patients treated with PMT. Methods: A retrospective review of IF-DVT patients treated with PMT was undertaken in a single tertiary center between January 2012 and 2017. The rate of PTS and QoL posttreatment was evaluated (follow-up range: 12–70 months, mean 32.3 months). Patients were invited to complete follow-up questionnaires (Villalta score and VEINES QoL/Sym). Results: Of 115 patients with IF-DVT, 42 were excluded (deceased, no intervention done, or only had CDT). 30 questionnaire replies (out of 73 PMT patients) were included in this study (41% return rate). 24/29 patients (83%) suffered from no or mild PTS symptoms, while the overall mean VEINES Sym/QoL scores were 75% and 76%, respectively. Direct correlation between the poorer PTS and VEINES Sym/QoL scores was observed. No statistically significant difference was seen between patients who were treated with/without stenting and compression stockings, neither their body mass index nor gender. Conclusion: There is a positive outcome in the symptoms of PTS and QoL among IF-DVT patients treated with PMT at long-term follow-up. Hence, PMT should be considered in this cohort. Improved patient selection factors targeting the most at-risk group should be further investigated.

 

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Publication History

Article published online:
26 April 2021