Factors Affecting Recurrent Deep Vein Thrombosis after Pharmacomechanical Thrombolysis and Left Iliac Vein Stent Placement in Patients with Iliac Vein Compression Syndrome.

PURPOSE: This study evaluated the factors affecting contralateral and ipsilateral recurrent deep vein thrombosis (DVT) after iliac vein stent placement in patients with iliac vein compression syndrome (IVCS).

MATERIALS AND

METHODS

Data from 130 patients (95 female patients) who underwent catheter-directed thrombolysis and stent placement for IVCS with left lower leg thrombosis at a single institution were retrospectively analyzed. Mean patient age was 69.0 ± 14.0 years old. Median follow-up was 14 months (range, 3-164 months). Anticoagulation therapy was prescribed for 6 months, followed by lifelong antiplatelet therapy. Multivariate logistic regression analysis was performed to evaluate the factors affecting the development of contralateral and ipsilateral recurrent DVT.

RESULTS

Seven patients (5.4%) developed contralateral DVT (median, 26 months; range, 2-61 months), and 11 patients (8.5%) developed ipsilateral DVT (median, 1 month; range, 0-53 months). Stent location (odds ratio [OR], 11.564; 95% confidence interval [CI], 1.159-115.417) and in-stent thrombosis during follow-up (OR, 15.142; 95% CI, 1.406-163.119) were predictors of recurrent contralateral DVT. Thrombophilia (OR, 47.560; 95% CI, 2.369-954.711), remaining inferior vena cava filter (OR, 30.552; 95% CI, 3.495-267.122), and in-stent thrombosis during follow-up (OR, 82.057; 95% CI, 2.915-2309.848) were predictors of ipsilateral DVT.

CONCLUSIONS

Contralateral DVT occurs late and is associated with extension of the iliac vein stent to the inferior vena cava and in-stent thrombosis. Ipsilateral DVT occurs relatively early and is associated with thrombophilia, remaining inferior vena cava filter, and in-stent thrombosis.