Technical Effectiveness and Clinical Outcomes of Mechanical Thrombectomy in Cancer Patients Presenting with IVC Filter-Associated Deep Venous Thrombosis: A Retrospective Study.

BACKGROUND

Deep venous thrombosis (DVT) in the presence of inferior vena cava (IVC) filters represents a challenging situation for the treatment in cancer patients due to the increased mortality and lack of thrombolytic options in this population. This study assessed the technical safety and efficacy of mechanical thrombectomy (MT) in cancer patients who presented with IVC filter-associated thrombosis and associated lower extremity DVT.

METHODS

A single-center retrospective study assessed MT in cancer patients who presented with IVC filter-associated thrombosis and lower extremity DVT from January 2019 to January 2024. Clinical response was defined as a reduction in symptoms per the Villalta score. Technical success was defined as the thrombus extraction from the affected vein, with patent lumen confirmed by digital subtraction angiography and/or intravascular ultrasound.

RESULTS

In total, 23 consecutive patients were included. The mean patient age was 57 years. Prior history of DVT was noted in 91.3% (n = 21/23) of patients. The mean symptom duration was 3.2 weeks (range: 1 day to 16 weeks). DVT location was unilateral DVT in 39.1% (n = 9), bilateral DVT in 56.5% (n = 13), and isolated IVC thrombosis in 4.3% (n = 1). Devices used included ClotTriever (17.4%, n = 4), FlowTriever (69.6%, n = 16), and a combination of both (13%, n = 3). The technical success rate was 100%, with no major intraprocedural complications (Common Terminology Criteria for Adverse Events ≥ 3). The clinical response rate was 91.3% (n = 21). The mean Villalta score decreased significantly from 7.32 (standard deviation 3.3) to 1.59 (standard deviation 0.9) (P < 0.001). The median overall survival was 34.6 months.

CONCLUSION

MT is safe and efficacious in reducing cancer patients' venous thromboembolism-associated symptoms in patients presenting with IVC filter-associated thrombosis.