Annals of African medicine · 2026
A Prospective Evaluation of Effects of Prompt Venous Procedures on Postthrombotic Syndrome in Proximal Deep Vein Thrombsis Cases - A Tertiary Care Hospital Study.
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Kiran Dayala Ravi, Jothieswari D
Аннотация
BACKGROUND: Proximal deep vein thrombosis (DVT) is often followed by Post-thrombotic syndrome (PTS), caused by a persistent venous obstruction and the dysfunction of the vein's valves. Anticoagulation is used to inhibit further propagation of the thrombus, but does not restore the patency of veins. Early venous interventions have been recommended to speed the resolution of the thrombus and to decrease the probability of remaining long term complications, but the evidence to support these interventions is limited.
OBJECTIVE: To compare the efficacy and safety of early venous intervention and anticoagulation to anticoagulation alone in patients with acute proximal lower-limb DVT.
METHODS: A prospective, observational cohort study was done in a Tertiary care hospital in Chittoor, India. A total of 157 patients with the initial occurrence of proximal (ie, above the ankle) venous thrombosis of the lower limbs (acute PLDVT) who presented within 14 days of symptom onset were enrolled. Patients were treated with either immediate venous intervention and anticoagulation (n=72) or only anticoagulation (n=85). Venous patency and residual thrombus burden, venous reflux, incidence of PTS based on Villalta score, VEINES-QOL/Sym scores, safety outcomes and healthcare utilization were assessed on follow-up at 6, 12, and 24 months.
RESULTS: The rate for complete venous patency was markedly different between the intervention and anticoagulation group at 6 (intervention 61.1% vs. anticoagulation 30.6%) and at 12 months (intervention 66.7% vs. anticoagulation 41.2%) with the intervention group having a higher rate. Residual thrombus burden was lower in the intervention group (29.2% at 6 months compared to 48.2%) and better in the VEINES-QOL/Sym scores over the course of the follow-up. Early intervention significantly lowered the risk of PTS (adjusted OR 0.18; 95% CI: 0.09-0.37) in children at 24 months. There were few high bleeding rates and they did not differ significantly between groups.
CONCLUSION: Early venous intervention and anticoagulation results in better venous patency, patient quality of life, and long-term clinical results, while decreasing the risk of PTS without increasing bleeding complications.
OBJECTIVE: To compare the efficacy and safety of early venous intervention and anticoagulation to anticoagulation alone in patients with acute proximal lower-limb DVT.
METHODS: A prospective, observational cohort study was done in a Tertiary care hospital in Chittoor, India. A total of 157 patients with the initial occurrence of proximal (ie, above the ankle) venous thrombosis of the lower limbs (acute PLDVT) who presented within 14 days of symptom onset were enrolled. Patients were treated with either immediate venous intervention and anticoagulation (n=72) or only anticoagulation (n=85). Venous patency and residual thrombus burden, venous reflux, incidence of PTS based on Villalta score, VEINES-QOL/Sym scores, safety outcomes and healthcare utilization were assessed on follow-up at 6, 12, and 24 months.
RESULTS: The rate for complete venous patency was markedly different between the intervention and anticoagulation group at 6 (intervention 61.1% vs. anticoagulation 30.6%) and at 12 months (intervention 66.7% vs. anticoagulation 41.2%) with the intervention group having a higher rate. Residual thrombus burden was lower in the intervention group (29.2% at 6 months compared to 48.2%) and better in the VEINES-QOL/Sym scores over the course of the follow-up. Early intervention significantly lowered the risk of PTS (adjusted OR 0.18; 95% CI: 0.09-0.37) in children at 24 months. There were few high bleeding rates and they did not differ significantly between groups.
CONCLUSION: Early venous intervention and anticoagulation results in better venous patency, patient quality of life, and long-term clinical results, while decreasing the risk of PTS without increasing bleeding complications.