Lin Zhang, Wei Song, Zheng Chen, Chuli Jiang, Yu Zhao, Fenghe Li
{"title":"下肢血栓形成后综合征患者血管内治疗后的四年预后。","authors":"Lin Zhang, Wei Song, Zheng Chen, Chuli Jiang, Yu Zhao, Fenghe Li","doi":"10.1016/j.jvsv.2025.102260","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the safety and efficacy of endovascular treatment for post-thrombotic syndrome (PTS) in the lower extremities, and to identify risk factors contributing to in-stent restenosis.</p><p><strong>Methods: </strong>Patients with PTS who underwent endovascular treatment at our institution from May 2016 to April 2022 were included in this study. Clinical symptoms were systematically assessed using the Villalta score, the Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification, and the Venous Clinical Severity Score. Primary and secondary patency rates were assessed by duplex ultrasound examination. Risk factors associated with in-stent restenosis were analyzed using univariate and multivariate Cox regression models. A repeated measures analysis of variance was conducted to compare clinical symptom scores before and after treatment.</p><p><strong>Results: </strong>A total of 115 patients were included in the study. The median follow-up duration was 48 months (range, 24-65 months). The primary patency rates at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years were 92.2% ± 2.5%, 88.7% ± 3.0%, 81.7% ± 3.6%, 73.9% ± 4.1%, 66.6% ± 4.5%, and 65.3% ± 4.6%, respectively. Stent restenosis was observed in 38 patients. At 1 year postoperatively, the Venous Clinical Severity Score exhibited a significant reduction of 7.0 (95% confidence interval [CI]. 6.0-8.0; P < .001) relative to preoperative levels. The Villalta score demonstrated a significant decrease of 11.4 (95% CI, 9.4-13.5; P < .001) compared with preoperative levels. Cox regression analysis indicated that a CEAP classification of C5 or C6 (hazard ratio, 2.24; 95% CI, 1.18-4.25; P = .014) was associated with stent restenosis.</p><p><strong>Conclusions: </strong>Endovascular treatment, with favorable long-term patency rates, is a safe and effective approach for managing PTS. CEAP classification of C5 or C6 has been identified as a risk factor for stent restenosis.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102260"},"PeriodicalIF":2.8000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Four-year outcomes following endovascular treatment in patients with post-thrombotic syndrome of the lower extremities.\",\"authors\":\"Lin Zhang, Wei Song, Zheng Chen, Chuli Jiang, Yu Zhao, Fenghe Li\",\"doi\":\"10.1016/j.jvsv.2025.102260\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to evaluate the safety and efficacy of endovascular treatment for post-thrombotic syndrome (PTS) in the lower extremities, and to identify risk factors contributing to in-stent restenosis.</p><p><strong>Methods: </strong>Patients with PTS who underwent endovascular treatment at our institution from May 2016 to April 2022 were included in this study. Clinical symptoms were systematically assessed using the Villalta score, the Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification, and the Venous Clinical Severity Score. Primary and secondary patency rates were assessed by duplex ultrasound examination. Risk factors associated with in-stent restenosis were analyzed using univariate and multivariate Cox regression models. A repeated measures analysis of variance was conducted to compare clinical symptom scores before and after treatment.</p><p><strong>Results: </strong>A total of 115 patients were included in the study. The median follow-up duration was 48 months (range, 24-65 months). The primary patency rates at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years were 92.2% ± 2.5%, 88.7% ± 3.0%, 81.7% ± 3.6%, 73.9% ± 4.1%, 66.6% ± 4.5%, and 65.3% ± 4.6%, respectively. Stent restenosis was observed in 38 patients. At 1 year postoperatively, the Venous Clinical Severity Score exhibited a significant reduction of 7.0 (95% confidence interval [CI]. 6.0-8.0; P < .001) relative to preoperative levels. The Villalta score demonstrated a significant decrease of 11.4 (95% CI, 9.4-13.5; P < .001) compared with preoperative levels. Cox regression analysis indicated that a CEAP classification of C5 or C6 (hazard ratio, 2.24; 95% CI, 1.18-4.25; P = .014) was associated with stent restenosis.</p><p><strong>Conclusions: </strong>Endovascular treatment, with favorable long-term patency rates, is a safe and effective approach for managing PTS. CEAP classification of C5 or C6 has been identified as a risk factor for stent restenosis.</p>\",\"PeriodicalId\":17537,\"journal\":{\"name\":\"Journal of vascular surgery. 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Four-year outcomes following endovascular treatment in patients with post-thrombotic syndrome of the lower extremities.
Objective: This study aimed to evaluate the safety and efficacy of endovascular treatment for post-thrombotic syndrome (PTS) in the lower extremities, and to identify risk factors contributing to in-stent restenosis.
Methods: Patients with PTS who underwent endovascular treatment at our institution from May 2016 to April 2022 were included in this study. Clinical symptoms were systematically assessed using the Villalta score, the Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification, and the Venous Clinical Severity Score. Primary and secondary patency rates were assessed by duplex ultrasound examination. Risk factors associated with in-stent restenosis were analyzed using univariate and multivariate Cox regression models. A repeated measures analysis of variance was conducted to compare clinical symptom scores before and after treatment.
Results: A total of 115 patients were included in the study. The median follow-up duration was 48 months (range, 24-65 months). The primary patency rates at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years were 92.2% ± 2.5%, 88.7% ± 3.0%, 81.7% ± 3.6%, 73.9% ± 4.1%, 66.6% ± 4.5%, and 65.3% ± 4.6%, respectively. Stent restenosis was observed in 38 patients. At 1 year postoperatively, the Venous Clinical Severity Score exhibited a significant reduction of 7.0 (95% confidence interval [CI]. 6.0-8.0; P < .001) relative to preoperative levels. The Villalta score demonstrated a significant decrease of 11.4 (95% CI, 9.4-13.5; P < .001) compared with preoperative levels. Cox regression analysis indicated that a CEAP classification of C5 or C6 (hazard ratio, 2.24; 95% CI, 1.18-4.25; P = .014) was associated with stent restenosis.
Conclusions: Endovascular treatment, with favorable long-term patency rates, is a safe and effective approach for managing PTS. CEAP classification of C5 or C6 has been identified as a risk factor for stent restenosis.
期刊介绍：
Journal of Vascular Surgery: Venous and Lymphatic Disorders is one of a series of specialist journals launched by the Journal of Vascular Surgery. It aims to be the premier international Journal of medical, endovascular and surgical management of venous and lymphatic disorders. It publishes high quality clinical, research, case reports, techniques, and practice manuscripts related to all aspects of venous and lymphatic disorders, including malformations and wound care, with an emphasis on the practicing clinician. The journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals who treat patients presenting with vascular and lymphatic disorders. As the official publication of The Society for Vascular Surgery and the American Venous Forum, the Journal will publish, after peer review, selected papers presented at the annual meeting of these organizations and affiliated vascular societies, as well as original articles from members and non-members.
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