Objectives: Studies addressing optimal postprocedural pharmacological management after endovascular stenting of iliofemoral post-thrombotic venous obstruction are lacking. We report our early clinical experience with a combination of rivaroxaban and clopidogrel in patients after iliofemoral post-thrombotic venous obstruction stenting.
Methods: Demographic, procedural, and follow-up data of nine patients (seven women; mean age of 32 ± 11 years) undergoing 10 procedures for iliofemoral post-thrombotic venous obstruction performed between August 2012 and January 2014 were retrospectively reviewed. After endovascular intervention, all patients were administered 20 mg rivaroxaban once daily (s.i.d.) and 75 mg clopidogrel s.i.d. or every second day depending on the individual drug responsiveness for at least six months. The adenosine diphosphate-induced platelet aggregation (platelet aggregation, in aggregation units × min) was assessed on a Multiplate analyzer. Patency was verified venographically at procedure end and was evaluated with duplex ultrasound in regular follow-ups.
Results: Iliofemoral venous flow was successfully re-established by percutaneous endovascular angioplasty and stent implantation in nine left-sided and one bilateral iliofemoral post-thrombotic venous obstruction. Under dual treatment strategy of rivaroxaban and clopidogrel with platelet aggregation control (median (range): 285 aggregation units × min (192; 402)), none of the patients experienced restenosis or stent thrombosis, respectively. After a median follow-up of 14 months (range: 6-26 months), the primary patency rate was 100% and no in-stent restenosis, stent occlusion or relevant minor or major bleeding occurred.
Conclusion: Combined factor Xa inhibition and tailored antiplatelet therapy after stenting of iliofemoral post-thrombotic venous obstruction were safe and performed favorably in terms of vessel patency.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/0268355515596289 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Endovascular therapy versus anticoagulation alone for subacute iliofemoral deep vein thrombosis.
J Vasc Interv Radiol
December 2024
Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China; Vascular Center of Shanghai JiaoTong University, Shanghai, China. Electronic address:
Purpose: This study evaluated whether endovascular therapy (ET) improved early symptom relief and decreased the incidence of moderate-to-severe post-thrombotic syndrome (PTS) compared to anticoagulation alone in patients with subacute (15-28 days) iliofemoral deep vein thrombosis (DVT).
Materials And Methods: Consecutive patients with subacute iliofemoral DVT from January 2020 to June 2022 were identified. A total of 86 patients were categorized to treatment with ET alongside anticoagulation (endovascular group, n = 49) or anticoagulation alone (anticoagulation group, n = 37).
Efficacy and safety of a dedicated venous stent for the treatment of iliofemoral venous obstruction: A single center experience.
Vascular
December 2024
Department of Vascular Surgery, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, China.
Background: Endovascular recanalization with venous stenting is the preferred treatment for iliofemoral venous obstruction. We reviewed our institutional experience and mid-term outcomes with endovascular therapy for iliofemoral venous obstruction using the Venovo Self-expanding Venous Stent (BARD Peripheral Vascular, Inc., Tempe, AZ, USA).
View Article and Find Full Text PDFTiming of Iliofemoral Vein Stent Implantation after Mechanical Thrombectomy for Acute Iliofemoral Venous Thrombosis.
Ann Vasc Surg
December 2024
Department of General Surgery, 218 Jixi Road, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China. Electronic address:
Objectives: Comparison of the treatment effects of immediate stent implantation vs staged stent implantation after AngioJet mechanical thrombectomy in patients with acute iliofemoral venous thrombosis.
Methods: A study included 80 patients with acute iliofemoral venous thrombosis formed between June 2021 and February 2023. They were divided into two groups: the direct implantation group (37 patients, 9 males) and the staged implantation group (43 patients, 10 males).
The role of inflow disease on patency of venous stents for post-thrombotic syndrome.
J Vasc Interv Radiol
December 2024
Department of Surgery, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Purpose: This study aimed to identify the risk of deep femoral vein (DFV) and/or femoral vein (FV) inflow disease on venous stent patency loss in post-thrombotic syndrome.
Methods: This single-center retrospective study included limbs with iliofemoral and ilocaval stents for PTS. Single-vessel and double-vessel inflow disease was defined based on imaging of possible post-thrombotic changes in the DFV/FV.
Assessing the Predictive Value of the Neutrophil-to-Lymphocyte Ratio for Post-Thrombotic Syndrome following Iliofemoral Deep Venous Thrombosis.
Ann Vasc Surg
November 2024
University of Maryland School of Medicine, Baltimore, MD; Division of Vascular Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, MD.
Article Synopsis
- Post-thrombotic syndrome (PTS) is a frequent complication following deep vein thrombosis (DVT), affecting 20-50% of patients and leading to a lower quality of life, with limited effective clinical predictors available for assessing PTS risk.
- A pilot study investigated the neutrophil-to-lymphocyte ratio (NLR), an indicator of systemic inflammation, as a potential predictive biomarker for PTS in patients diagnosed with iliofemoral DVT.
- The study found that an NLR cut-off of 7.71 could significantly predict PTS, with 36.44% of patients experiencing the syndrome, suggesting that NLR could be a useful tool in evaluating PTS risk alongside other clinical markers.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!