Endovascular Intervention Among Patients Complicated by Acute Inferior Deep Venous Thrombosis: A Single-Center Retrospective Cohort Study From Vietnam.
Van Nut Lam, Duc Tin Le, Manh Hung Nguyen, Thuy Vy Tran Thi, Phuc Nhon Nguyen
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Abstract
Background: The study was aimed at evaluating the efficacy, safety, and outcomes of endovascular intervention (EVT) among patients with acute inferior deep vein thrombosis (DVT), as well as revealing the risk factors associated with postthrombotic syndrome (PTS) in these patients.
Methods: This retrospective study was conducted at the Department of Vascular Surgery, C.R. Hospital, Vietnam. The study enrolled all the patients diagnosed with acute lower limb DVT and underwent EVT (thromboaspiration, thrombolysis, balloon angioplasty, and stent placement) between January 2017 and December 2022. All the patients were recorded with treatment outcomes, postinterventional complications, and factors relating to PTS on the follow-up at 1 week and at 1 month after intervention.
Results: A total of 37 patients met the inclusion criteria. Baseline characteristics included a mean age of 55.8 ± 13.3 years, female sex (75.5%), body mass index (BMI) ≥ 23 kg/m2 (63.2%), and inferior DVT on the left side (91.9%). Location of thrombus was noted at the iliac vein (97.3%), the femoral vein (70.3%), and the popliteal vein (97.3%). Postoperative length of stay was 5.5 ± 2.7 days, and clinical symptoms reduced in 2.5 ± 0.9 days. There were two cases of bleeding at the interventional site and two cases of death. Partial stenosis at 1 week and 1 month regarding the iliac vein, the femoral vein, and the popliteal vein was 71.4% and 54.3%, 14.3% and 37.1%, and 20.0% and 40.0%, respectively. None of the cases were observed with complete stenosis. In addition, 62.9% of cases reported no PTS. 37.1% of cases were noted with mild PTS. Advanced age, high BMI, duration time of thrombolysis, and underlying diseases were all associated factors relating to PTS. Noticeably, comorbidities and overweight/obesity increased 18.7- and 17.33-fold risk of PTS (p < 0.05), respectively.
Conclusions: EVT is an acceptable alternative method in the treatment of acute inferior DVT. A decision-making of EVTs for acute lower limb DVT should be implemented after assessment of risk factors in large centers with professional conditions and facilities.
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