Kristijonas Milinis1, Ankur Thapar2, Joseph Shalhoub3, Alun H Davies4. 1. Imperial College London, London, UK. 2. London Postgraduate School of Surgery and Imperial College London, London, UK. 3. Imperial College Healthcare NHS Trust and Imperial College London, London, UK. 4. Imperial College London, London, UK. Electronic address: a.h.davies@imperial.ac.uk.
Abstract
OBJECTIVE/ BACKGROUND: Deep venous stenting is increasingly used in the treatment of deep venous obstruction; however, there is currently no consensus regarding post-procedural antithrombotic therapy. The aim of the present study was to determine the most commonly used antithrombotic regimens and facilitate global consensus. METHODS: An electronic survey containing three clinical scenarios on venous stenting for non-thrombotic iliac vein lesions, acute deep vein thrombosis (DVT), and post-thrombotic syndrome was distributed to five societies whose members included vascular surgeons, interventional radiologists, and haematologists. The results of the initial survey (phase 1) were used to produce seven consensus statements, which were distributed to the respondents for evaluation in the second round (phase 2), along with the results of phase 1. Consensus was defined a priori as endorsement or rejection of a statement by ≥ 67% of respondents. RESULTS: Phase 1 was completed by 106 experts, who practiced in 78 venous stenting centres in 28 countries. Sixty-one respondents (58% response rate) completed phase 2. Five of seven statements met the consensus criteria. Anticoagulation was the preferred treatment during the first 6-12 months following venous stenting for a compressive iliac vein lesion. Low molecular weight heparin was the antithrombotic agent of choice during the first 2-6 weeks. Lifelong anticoagulation was recommended after multiple DVTs. Discontinuation of anticoagulation after 6-12 months was advised following venous stenting for a single acute DVT. No agreement was reached regarding the role of long-term antiplatelet therapy. CONCLUSIONS: Consensus existed amongst respondents regarding anticoagulant therapy following venous stenting. At present, there is no consensus regarding the role of antiplatelet agents in this context.
OBJECTIVE/ BACKGROUND: Deep venous stenting is increasingly used in the treatment of deep venous obstruction; however, there is currently no consensus regarding post-procedural antithrombotic therapy. The aim of the present study was to determine the most commonly used antithrombotic regimens and facilitate global consensus. METHODS: An electronic survey containing three clinical scenarios on venous stenting for non-thrombotic iliac vein lesions, acute deep vein thrombosis (DVT), and post-thrombotic syndrome was distributed to five societies whose members included vascular surgeons, interventional radiologists, and haematologists. The results of the initial survey (phase 1) were used to produce seven consensus statements, which were distributed to the respondents for evaluation in the second round (phase 2), along with the results of phase 1. Consensus was defined a priori as endorsement or rejection of a statement by ≥ 67% of respondents. RESULTS: Phase 1 was completed by 106 experts, who practiced in 78 venous stenting centres in 28 countries. Sixty-one respondents (58% response rate) completed phase 2. Five of seven statements met the consensus criteria. Anticoagulation was the preferred treatment during the first 6-12 months following venous stenting for a compressive iliac vein lesion. Low molecular weight heparin was the antithrombotic agent of choice during the first 2-6 weeks. Lifelong anticoagulation was recommended after multiple DVTs. Discontinuation of anticoagulation after 6-12 months was advised following venous stenting for a single acute DVT. No agreement was reached regarding the role of long-term antiplatelet therapy. CONCLUSIONS: Consensus existed amongst respondents regarding anticoagulant therapy following venous stenting. At present, there is no consensus regarding the role of antiplatelet agents in this context.
Authors: Antoni Riera-Mestre; Luis Jara-Palomares; Ramón Lecumberri; Javier Trujillo-Santos; Enric Grau; Angeles Blanco-Molina; Ana Piera Carbonell; Sonia Jiménez; Manuel Frías Vargas; Mari Paz Fuset; Sergi Bellmunt-Montoya; Manuel Monreal; David Jiménez Journal: Viruses Date: 2021-10-22 Impact factor: 5.048
Authors: Pascale Notten; Jorinde H H van Laanen; Pieter Eijgenraam; Mark A F de Wolf; Ralph L M Kurstjens; Hugo Ten Cate; Arina J Ten Cate-Hoek Journal: Res Pract Thromb Haemost Date: 2020-04-08