Annals of vascular surgery · 2025
Comparison of Endovascular Therapy Versus Anticoagulation Alone for the Treatment of Subacute Iliofemoral Deep Vein Thrombosis in Elderly Patients: Measures of 2-Year Clinical Outcome and Quality of Life.
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Hu Dinghai, Huang Lihua, Lu Yong, Feng Wei, Hong Xin, Chen Zhuo, Huang Tianan
Аннотация
BACKGROUND: To study the safety outcomes and the subsequent occurrence of post-thrombotic syndrome (PTS) after endovascular therapy (ET) combined with anticoagulation versus anticoagulation alone (AC) in treatment of subacute iliofemoral deep vein thrombosis (IFDVT) in elderly patients.
METHODS: A retrospective analysis of the clinical data of consecutive elderly patients hospitalized for subacute IFDVT between January 2021 and January 2023 was conducted. According to the treatment, patients were divided into the ET group and the AC group. The safety outcomes, the occurrence of PTS, and differences in Chronic Venous Insufficiency Questionnaire (CIVIQ) score within 2 years were compared between the groups.
RESULTS: The data of 121 patients were analyzed, among which 53 were in the ET group and 68 in the AC group. No significant differences were observed in any bleeding events, catheter-related infection, acute renal insufficiency, or symptomatic pulmonary embolism between groups. During the 2-year follow-up, there was no significant difference in the incidence of PTS (defined as a Villalta score ≥ 5 or ulcer: 45.3% vs. 55.9%; P = 0.275). However, the severity of PTS differed significantly between groups (Villalta score ≥ 15 or ulcer: 17.0% vs. 35.3%; P = 0.039; Venous Clinical Severity Score ≥ 8: 13.2% vs. 33.8%; P = 0.011). In addition, the CIVIQ score showed a statistically significant difference [(62.57 ± 12.03) vs. (56.79 ± 10.70); P = 0.006].
CONCLUSION: In elderly patients with subacute IFDVT, ET demonstrated similar safety outcomes to AC. Moreover, ET significantly reduced the incidence of severe PTS and led to greater improvement in venous disease-specific quality of life.
METHODS: A retrospective analysis of the clinical data of consecutive elderly patients hospitalized for subacute IFDVT between January 2021 and January 2023 was conducted. According to the treatment, patients were divided into the ET group and the AC group. The safety outcomes, the occurrence of PTS, and differences in Chronic Venous Insufficiency Questionnaire (CIVIQ) score within 2 years were compared between the groups.
RESULTS: The data of 121 patients were analyzed, among which 53 were in the ET group and 68 in the AC group. No significant differences were observed in any bleeding events, catheter-related infection, acute renal insufficiency, or symptomatic pulmonary embolism between groups. During the 2-year follow-up, there was no significant difference in the incidence of PTS (defined as a Villalta score ≥ 5 or ulcer: 45.3% vs. 55.9%; P = 0.275). However, the severity of PTS differed significantly between groups (Villalta score ≥ 15 or ulcer: 17.0% vs. 35.3%; P = 0.039; Venous Clinical Severity Score ≥ 8: 13.2% vs. 33.8%; P = 0.011). In addition, the CIVIQ score showed a statistically significant difference [(62.57 ± 12.03) vs. (56.79 ± 10.70); P = 0.006].
CONCLUSION: In elderly patients with subacute IFDVT, ET demonstrated similar safety outcomes to AC. Moreover, ET significantly reduced the incidence of severe PTS and led to greater improvement in venous disease-specific quality of life.