Medium- and long-term efficacy of percutaneous mechanical thrombectomy with stent implantation in patients with iliac vein stenosis and thrombosis.

Abstract

Objectives: To investigate the medium- and long-term efficacy of Percutaneous mechanical thrombectomy (PMT) combined with stent implantation for treatment of iliac vein stenosis with lower limb deep vein thrombosis.

Methods: Clinical and follow-up data of 125 patients with iliac vein stenosis and lower limb deep vein thrombosis who underwent PMT and stent implantation at five hospitals in northern Zhejiang province from January 2017 to June 2021 were collected. The thrombus clearance rate, thrombus recurrence rate, post-thrombotic syndrome (PTS) occurrence rate and the patency rate of iliac vein stents were documented,and safety indicators such as bleeding, death, pulmonary embolism, stent fracture and displacement were assessed.

Results: Among 125 patients, for clearance rate of limb thrombosis, there were 8 cases of grade Ⅰ (6.4%), 10 cases of grade Ⅱ (8.0%), and 107 cases of grade Ⅲ (85.6%). Patients were followed up for a median period of 74 months. According to the Villalta score, the recurrence rate of limb thrombosis at 12, 24 and 36 months was 8.48%, 8.93% and 10.91%; the iliac vein patency rates were 91.52%, 91.07%, and 89.09%; and the incidence of PTS was 5.08%, 5.36% and 6.36%, respectively. There were no major safety events such as death, massive pulmonary embolism and severe hepatic and renal insufficiency, and no readmission intervention events due to stent fracture or other incidence were found.

Conclusions: Percutaneous mechanical thrombectomy combined with iliac vein stent implantation is effective for patients with iliac vein stenosis complicated by lower extremity deep vein thrombosis with good medium- and long-term efficacy and safety, which is worthy of clinical application.