Predictive Factors for Complete Recovery of Post-thrombotic Syndrome 6 Months after Venous Recanalization.

Abstract

Objective: Endovascular recanalization is considered for severely symptomatic patients with post-thrombotic syndrome (PTS) to alleviate symptoms. However, data on complete recovery and its predictors remain limited. This study aimed to assess persistent PTS six months after venous recanalization and identify predictive factors.

Design: Single-center retrospective outcome-oriented cohort study.

Methods: We reviewed electronic medical records of patients referred for endovascular venous recanalization between January 1, 2015, and September 30, 2019. Inclusion criteria were PTS defined by a Villalta score ≥ 5 or a leg ulcer at least six months after a deep vein thrombosis (DVT) episode. Complete PTS recovery was defined as a Villalta score < 5.

Results: Sixty-seven patients (median age: 40 years [IQR 32-51], 78% women, 18% obese) were included. The initial Villalta score was 10 [IQR 7-14]. At six months, primary and secondary patency rates were 75% and 81%, respectively. Complete recovery was observed in 67% of patients. Multivariate analysis identified the initial Villalta score (OR 1.36, 95% CI 1.12-1.65, p = .002) and femoral vein obstruction (OR 3.79, 95% CI 1.06-13.61, p = .041) as predictors of persistent PTS, whereas long-term anticoagulation was not significant.

Conclusion: Endovascular recanalization achieved PTS resolution in two-thirds of patients at six months, particularly in those with a low initial Villalta score and no femoral vein obstruction. A risk score incorporating these factors may aid clinicians in patient counseling regarding the expected benefits of the procedure.