Abstract | BACKGROUND: Iliofemoral deep vein thrombosis (DVT) is associated with severe postthrombotic morbidity when treated with anticoagulation alone. Catheter-directed thrombolysis (CDT), with or without the addition of mechanical techniques, is increasingly recommended for patients with iliofemoral DVT, although its effect on postthrombotic syndrome is not established. This study examined the correlation of residual thrombus with postthrombotic syndrome after catheter-based attempts at thrombus removal in patients with iliofemoral DVT. METHODS: Seventy-one consecutive patients with iliofemoral DVT were treated with CDT. Pretreatment and posttreatment phlebograms were evaluated for quantity of residual thrombus by physicians blinded to clinical patient outcomes. Postthrombotic syndrome was assessed using CEAP and Villalta scores by examiners blinded to phlebographic results. Patients were grouped by the amount of residual thrombus in treated vein segments (group 1, ≤50%; group 2, >50%). Clinical score and postthrombotic outcomes were plotted vs residual thrombus. RESULTS: Sixty-three of 71 patients completed CEAP and Villalta analyses. Groups 1 and 2 had median CEAP scores of 1 and 4 (P = .025) and mean Villalta scores of 2.21 and 7.13, respectively (P = .011). There was a direct and significant correlation of clinical class of CEAP with residual thrombus (R(2) = .74; P = .004) and a direct linear correlation of Villalta score with residual thrombus (R(2) = .61; P = .0014). CONCLUSIONS:
|
Authors | Anthony J Comerota, Nina Grewal, Jorge Trabal Martinez, John Tahao Chen, Robert Disalle, Linda Andrews, Deb Sepanski, Zakaria Assi |
Journal | Journal of vascular surgery
(J Vasc Surg)
Vol. 55
Issue 3
Pg. 768-73
(Mar 2012)
ISSN: 1097-6809 [Electronic] United States |
PMID | 22277690
(Publication Type: Journal Article)
|
Copyright | Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. |
Chemical References |
|
Topics |
- Catheterization
(adverse effects)
- Female
- Femoral Vein
(diagnostic imaging)
- Fibrinolytic Agents
(administration & dosage, adverse effects)
- Humans
- Iliac Vein
(diagnostic imaging)
- Linear Models
- Male
- Mechanical Thrombolysis
(adverse effects)
- Middle Aged
- Ohio
- Phlebography
- Postthrombotic Syndrome
(diagnostic imaging, etiology, prevention & control)
- Predictive Value of Tests
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Thrombolytic Therapy
(adverse effects)
- Time Factors
- Treatment Outcome
- Venous Thrombosis
(complications, diagnostic imaging, therapy)
|