Timing of Iliofemoral Vein Stent Implantation after Mechanical Thrombectomy for Acute Iliofemoral Venous Thrombosis.

BACKGROUND

Comparison of the treatment effects of immediate stent implantation versus 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 2 groups: the direct implantation group (37 patients, 9 males) and the staged implantation group (43 patients, 10 males). Venous angiography and Villata scoring were used to assess patency rates and the occurrence of postthrombotic syndrome (PTS). A 1-year follow-up was conducted and a multiple-factor Cox regression model was used to analyze the clinical factors affecting patency rates.

RESULTS

Surgery was successfully completed without serious complications or deaths during follow-up. The direct implantation group had significantly shorter hospital stays and surgical times compared to the staged implantation group (P < 0.001). Both groups showed a decrease in Villata scores (P < 0.001), and the direct group had higher scores than the staged group at 12 months postsurgery (P < 0.001). One year after the procedure, there was no significant difference in stent patency rates (P = 0.658), but postoperative scores at 1 month (P = 0.012) and stent length (P = 0.015) had a significant impact.

CONCLUSIONS

For acute iliofemoral venous thrombosis, both direct stent implantation and staged implantation are effective. The direct implantation procedure has shorter hospital stays and surgical times, whereas staged implantation has a lower long-term risk of PTS. Villata scores at 1 month after surgery can predict the risk of vascular obstruction. Longer stents may reduce the risk of postoperative obstruction.