Clinical efficacy of simultaneous versus staged stent implantation after percutaneous mechanical thrombectomy in IVCS patients with acute IFDVT.

Objectives: To assess the clinical outcomes and prognoses of various stent implantation timings after percutaneous mechanical thrombectomy (PMT) in patients with iliac vein compression syndrome (IVCS) complicated by acute iliofemoral deep vein thrombosis (IFDVT).

Methods: A total of 99 patients diagnosed with IVCS with acute IFDVT from December 2016 to February 2024 at our institution were retrospectively analyzed. Patients were divided into 2 groups: Group A underwent simultaneous iliac vein stent implantation, while Group B received staged stent implantation after local urokinase thrombolysis. The 2 groups were compared on the basis of limb edema resolution within 3 days postsurgery, urokinase doses, hospitalization duration, and in-stent patency during follow-up.

Results: During the follow-up, the stent occlusion rates were comparable between the 2 groups. Compared with Group B, Group A experienced faster limb edema resolution within 3 days postsurgery and required lower urokinase doses and a shorter hospitalization duration. In Group B, 13 patients needed additional stent implantation due to iliac vein occlusion after thrombolysis.

Conclusion: Simultaneous iliac vein stent implantation, as opposed to staged placement after PMT, improved limb edema resolution within 3 days, reduced urokinase doses, and shortened hospital stays.