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Background
Deep vein thrombosis (DVT) is a common cardiovascular emergency that may have life-threatening complications, including pulmonary embolism (PE) and post-thrombotic syndrome (PTS). Conventional anticoagulant medication does not completely dissolve the clots and does not decrease the risk of DVT complications. Invasive catheter-directed th...
Context in source publication
Context 1
... difference of thigh circumference between the affected and contralateral limbs decreased from 5.37 AE 1.97 to 2.96 AE 1.10 in group A (t ¼ 8.35, P < 0.0001) and from 5.41 AE 2.22 to 1.78 AE 1.40 in group B (t ¼ 12.35 P < 0.0001). The difference of calf circumference between the affected and contralateral limbs decreased from 4.14 AE 1.57 to 1.93 AE 0.84 in group A (t ¼ 8.89, P < 0.0001) and from 4.05 AE 1.61 to 1.41 AE 1.17 in group B (t ¼ 9.24, P < 0.0001) ( Table 2). ...Similar publications
Background
It is unclear whether cardiopulmonary exercise intolerance in patients with chronic obstruction of the inferior vena cava (IVC) is reversible following endovascular IVC reconstruction.
Methods
In 17 patients (mean age 45 ± 15 years, 71% men) with post-thrombotic syndrome due to IVC obstruction and preserved left ventricular ejection fra...
Citations
... [ 20] In addition, the risk of bleeding is substantially increased in patients with cancer because of the risk of thrombocytopenia after treatment, which has led to concerns regarding the use of anticoagulant drugs in these patients. [21][22][23] In the current study, 240 (18.2%) patients had active cancer, lter placement was performed because of poor general condition, insu cient anticoagulation, and progression or recurrence of VTE. 183 (76.3%) of these were found to have DVT progression or large residual DVT at the time of proposed lter retrieval. ...
Objective
To develop and validate a nomogram for predicting non-retrieval of the short-term retrievable inferior vena cava (IVC) filters.
Methods
In this study, univariate and multivariate logistic regression analyses were performed to identify predictive factors of short-term retrievable filter non-retrieval, and a nomogram was then established based on these factors. The nomogram was created based on data from a training cohort and validated based on data from a validation cohort. The predictive value of the nomogram was estimated using area under the curve (AUC) and calibration curve analysis (Hosmer-Lemeshow test).
Results
A total of 1321 patients who had undergone placement of short-term retrievable filters (Aegisy or OptEase) were included in the analysis. The overall retrieval rate was. Age, mixed type deep vein thrombosis (DVT) vs peripheral type DVT, active cancer, history of long-term immobilization, VTE was detected in the intensive care unit, active/recurrent bleeding, IVC thrombosis, and history of venous thromboembolism were independent predictive risk factors for non-retrieval of filters. Interventional therapy for DVT, fresh fracture, and interval of ≥ 14 days between filter placement and patient discharge were independent protective factors for non-retrieval of filters. The nomogram based on these factors demonstrated good ability to predict the non-retrieval of filters (training cohort AUC = 0.870; validation cohort AUC = 0.813.
Conclusion
This nomogram demonstrated strong predictive accuracy and discrimination capability. This model may help clinicians identify patients who are not candidates for short-term retrievable filter placement and help clinicians make timely, individualized decisions in filter choice strategies.
Objectives
The objective of this study was to describe the contribution and advantage of balloon-dilatation of iliac and femoral veins following pharmacomechanical catheter-directed thrombolysis (PCDT) on the development of post-thrombotic syndrome (PTS).
Methods
From October 2018 and January 2022, 85 patients with acute total occlusion of the iliac and femoral veins were treated with PCDT. The cohort was divided into two groups depending on the utilization of concomitant balloon dilatation of iliac and femoral veins (Group 1, n=34, 40.0%) or not (Group 2, n=51, 60.0%) during the PCDT. All patients underwent duplex ultrasound scanning for evaluating the patency of iliac veins and recanalization rates at 3, 6, and 12 months postoperatively. the Villalta score was used to score the severity of PTS at 12 months postoperatively.
Results
Patients who underwent balloon-assisted PCDT (group 1) exhibited significantly higher primary patency rates in CIV (recanalization 84.3 ± 14.6%, p = 0.003) , EIV (recanalization 82.8 ± 17.2, p = 0.003) and CFV (recanalization 88.1 ± 12.1%, p = 0.038) compared with the group 2 at the end of 12 months follow-up. Only 2 patients underwent venous stenting in follow-up due to severe venous claudication, however, 13 patients were required iliac vein stenting due to severe PTS proved with a high Villalta score at 12-month follow-up. The d-dimer level at 1-year follow-up had also significantly lower in Group 1 due to higher rates of patency and lower thrombosis burden. The most common bleeding events were hematuria (n =4) or oozing in the puncture site (n = 4).
Conclusions
This study showed that balloon-assisted PCDT reduces the risk of PTS, is more successful in common iliac vein recanalization, reduces the need for the venous stent, and even lowers the D-dimer levels of the patients compared to routine PCDT alone.
