Annals of vascular surgery · 2026
Two-Year Comparative Outcomes of Four Early Clot Removal Techniques for Deep Vein Thrombosis.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Ozsoy Ozgur, Ugur Murat, Caglar Karakaya Haluk, Turhan Muhammet
Аннотация
BACKGROUND: Despite full adherence to treatment, patients with acute iliofemoral deep vein thrombosis (IFDVT) remain at high risk for developing postthrombotic syndrome (PTS). Consequently, endovascular strategies such as early thrombus removal and catheter-directed thrombolysis (CDT) have been developed. In this study, we compared the long-term effectiveness of endovascular thrombectomy techniques and CDT available at our institution.
METHODS: We retrospectively analyzed 91 adults with acute IFDVT who underwent endovascular interventions between 2019 and 2023. Patients were stratified into four groups (G1, G2, G3, G4): CDT (n = 27), AngioJet rheolytic (n = 27), AngioJet Power Pulse (n = 17), and Mantis rotational thrombectomy (n = 20). The primary outcome was the development of PTS at 24 months, assessed using Villalta and the venous clinical severity score. Secondary outcomes included complications, major and minor bleeding events, and recurrent thrombosis.
RESULTS: Among the 91 patients, the mean age was 51.2 ± 18.1 years, 51.6% were male, and the mean body mass index was 27.6 ± 3.7 kg/m2. At 24 months, PTS assessed by the Villalta score showed no significant differences among groups (P = 0.279). In G1, 51.9% had no PTS, 29.6% mild, 14.8% moderate, and 3.7% severe; in G2, 59.3% had no PTS, 29.6% mild, 3.7% moderate, and 7.4% severe; in G3, 64.7% had no PTS, 5.9% mild, 11.8% moderate, and 17.6% severe; and in G4, 70% had no PTS, 20% mild, 0% moderate, and 10% severe. Major bleeding occurred in 0-7.4% of patients, minor bleeding in 7-18.5%, and acute kidney injury in 5-35.3%, with no cases of perioperative mortality or pulmonary embolism. Recurrence was observed in G1 (3.7%) and G3 (23.5%), with a statistically significant difference between groups (P = 0.004).
CONCLUSION: In conclusion, our study found no significant differences among endovascular techniques regarding PTS development. All methods were generally safe, although recurrence rates varied across techniques.
METHODS: We retrospectively analyzed 91 adults with acute IFDVT who underwent endovascular interventions between 2019 and 2023. Patients were stratified into four groups (G1, G2, G3, G4): CDT (n = 27), AngioJet rheolytic (n = 27), AngioJet Power Pulse (n = 17), and Mantis rotational thrombectomy (n = 20). The primary outcome was the development of PTS at 24 months, assessed using Villalta and the venous clinical severity score. Secondary outcomes included complications, major and minor bleeding events, and recurrent thrombosis.
RESULTS: Among the 91 patients, the mean age was 51.2 ± 18.1 years, 51.6% were male, and the mean body mass index was 27.6 ± 3.7 kg/m2. At 24 months, PTS assessed by the Villalta score showed no significant differences among groups (P = 0.279). In G1, 51.9% had no PTS, 29.6% mild, 14.8% moderate, and 3.7% severe; in G2, 59.3% had no PTS, 29.6% mild, 3.7% moderate, and 7.4% severe; in G3, 64.7% had no PTS, 5.9% mild, 11.8% moderate, and 17.6% severe; and in G4, 70% had no PTS, 20% mild, 0% moderate, and 10% severe. Major bleeding occurred in 0-7.4% of patients, minor bleeding in 7-18.5%, and acute kidney injury in 5-35.3%, with no cases of perioperative mortality or pulmonary embolism. Recurrence was observed in G1 (3.7%) and G3 (23.5%), with a statistically significant difference between groups (P = 0.004).
CONCLUSION: In conclusion, our study found no significant differences among endovascular techniques regarding PTS development. All methods were generally safe, although recurrence rates varied across techniques.