Arthur David1, Frédéric Thony2, Costantino Del Giudice3,4,5,6, Gilles Goyault7, Romaric Loffroy8, Kévin Guillen8, Yann Le Bras9, Clément Marcelin9, Valérie Monnin-Bares10, Jean-François Heautot11, Alexandre Lablee11, Pierre Marek12, Hervé Rousseau12, Thomas Martinelli13, Francine Thouveny14, Pierre-Antoine Barral15, Vincent Le Pennec16, Pascal Chabrot17,18, André Rogopoulos19, Alicia Guillien20, Marc Sapoval3,4,5, Matthieu Rodière2, Olivier Espitia21, Frédéric Douane22. 1. Department of Radiology, Nantes University Hospital, University of Medicine of Nantes, Service de Radiologie Centrale du Centre Hospitalier Universitaire de Nantes, 1, place Alexis Ricordeau, 44093, Nantes, France. arthur.david@chu-nantes.fr. 2. Department of Imaging and Interventional Radiology, Grenoble-Alpes University Hospital (CHUGA), Grenoble, France. 3. Vascular and Oncological Interventional Radiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France. 4. Université de Paris, Paris, France. 5. Imagerie de L'Angiogenèse, INSERM URM 970 Équipe 2, 75015, Paris, France. 6. Institut Mutualiste Montsouris, Paris, France. 7. Department of Vascular and Oncological Interventional Radiology, Institut Cardiovasculaire de Strasbourg (ICS), Clinique Rhena, Strasbourg, France. 8. Department of Vascular Medicine and Interventional Radiology, François-Mitterrand University Hospital, Dijon, France. 9. Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, Bordeaux, France. 10. Department of Imaging and Interventional Radiology, Montpellier University Hospital (CHU), Montpellier, France. 11. Radiology Department, University Hospital Pontchaillou, Rennes, France. 12. Radiology Department, CHU Rangueil, Toulouse University Hospital, Toulouse, France. 13. Department of Medical Imaging and Radiology, Valence Hospital, Valence, France. 14. Vascular Radiology, University Hospital, Angers, France. 15. Department of Radiology, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, Marseille, France. 16. Department of Interventional and Diagnostic Imaging, University Hospital of Caen, Caen Cedex, France. 17. Department of Vascular Radiology, CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Clermont-Ferrand, France. 18. UMR Auvergne CNRS 6284, Clermont-Ferrand Faculty of Medicine, Clermont-Ferrand, France. 19. Department of Radiology, Institut Arnault Tzanck, Saint-Laurent du Var, France. 20. Equipe d'Epidémiologie Environnementale, Institute for Advanced Biosciences, Centre de Recherche UGA, UMR 5309, INSERM U1209, CNRS, Grenoble, France. 21. Department of Internal Medicine, Nantes University Hospital, Nantes, France. 22. Department of Radiology, Nantes University Hospital, University of Medicine of Nantes, Service de Radiologie Centrale du Centre Hospitalier Universitaire de Nantes, 1, place Alexis Ricordeau, 44093, Nantes, France.
Abstract
PURPOSE: To assess the results of endovascular treatment in a large population of patients suffering from post-thrombotic syndrome (PTS) due to iliocaval occlusive disease. METHODS: In this retrospective multi-center study, 698 patients treated by stenting for PTS in 15 French centers were analyzed. Primary, primary assisted, and secondary patency rates were assessed, and clinical efficacy was evaluated using Villalta and Chronic Venous Insufficiency Questionnaire in 20 questions (CIVIQ-20) scores. Outcomes were compared against pre-operative CT-based severity of the post-thrombotic lesions in the thigh (4 grades). RESULTS: Technical success, defined as successful recanalization and stent deployment restoring rapid anterograde flow in the targeted vessel, was obtained in 668 (95.7%) patients with a complication rate of 3.9%. After a mean follow-up of 21.0 months, primary patency, primary assisted patency, and secondary patency were achieved in 537 (80.4%), 566 (84.7%), and 616 (92.2%) of the 668 patients, respectively. Venous patency was strongly correlated to the grade of post-thrombotic changes in the thigh, with secondary patency rates of 96.0%, 92.9%, 88.4%, and 78.9%, respectively, for grades 0 to 3 (p = .0008). The mean improvements of Villalta and CIVIQ-20 scores were 7.0 ± 4.7 points (p < .0001) and 19.1 ± 14.8 points (p < .0001), respectively. CONCLUSION: Endovascular stenting as a treatment option for PTS due to chronic iliocaval venous occlusion generates a high technical success, low morbidity, high midterm patency rate, and clinical improvement. Venous patency was strongly correlated to the severity of post-thrombotic lesions in the thigh.
PURPOSE: To assess the results of endovascular treatment in a large population of patients suffering from post-thrombotic syndrome (PTS) due to iliocaval occlusive disease. METHODS: In this retrospective multi-center study, 698 patients treated by stenting for PTS in 15 French centers were analyzed. Primary, primary assisted, and secondary patency rates were assessed, and clinical efficacy was evaluated using Villalta and Chronic Venous Insufficiency Questionnaire in 20 questions (CIVIQ-20) scores. Outcomes were compared against pre-operative CT-based severity of the post-thrombotic lesions in the thigh (4 grades). RESULTS: Technical success, defined as successful recanalization and stent deployment restoring rapid anterograde flow in the targeted vessel, was obtained in 668 (95.7%) patients with a complication rate of 3.9%. After a mean follow-up of 21.0 months, primary patency, primary assisted patency, and secondary patency were achieved in 537 (80.4%), 566 (84.7%), and 616 (92.2%) of the 668 patients, respectively. Venous patency was strongly correlated to the grade of post-thrombotic changes in the thigh, with secondary patency rates of 96.0%, 92.9%, 88.4%, and 78.9%, respectively, for grades 0 to 3 (p = .0008). The mean improvements of Villalta and CIVIQ-20 scores were 7.0 ± 4.7 points (p < .0001) and 19.1 ± 14.8 points (p < .0001), respectively. CONCLUSION: Endovascular stenting as a treatment option for PTS due to chronic iliocaval venous occlusion generates a high technical success, low morbidity, high midterm patency rate, and clinical improvement. Venous patency was strongly correlated to the severity of post-thrombotic lesions in the thigh.
Authors: P Prandoni; A W Lensing; A Cogo; S Cuppini; S Villalta; M Carta; A M Cattelan; P Polistena; E Bernardi; M H Prins Journal: Ann Intern Med Date: 1996-07-01 Impact factor: 25.391
Authors: S R Kahn; H Shbaklo; D L Lamping; C A Holcroft; I Shrier; M J Miron; A Roussin; S Desmarais; F Joyal; J Kassis; S Solymoss; L Desjardins; M Johri; J S Ginsberg Journal: J Thromb Haemost Date: 2008-06-01 Impact factor: 5.824