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  • Title: Factors Affecting Recurrent Deep Vein Thrombosis after Pharmacomechanical Thrombolysis and Left Iliac Vein Stent Placement in Patients with Iliac Vein Compression Syndrome.
    Author: Kim KY, Hwang HP, Han YM.
    Journal: J Vasc Interv Radiol; 2020 Apr; 31(4):635-643. PubMed ID: 32127319.
    Abstract:
    PURPOSE: This study evaluated the factors affecting contralateral and ipsilateral recurrent deep vein thrombosis (DVT) after iliac vein stent placement in patients with iliac vein compression syndrome (IVCS). MATERIALS AND METHODS: Data from 130 patients (95 female patients) who underwent catheter-directed thrombolysis and stent placement for IVCS with left lower leg thrombosis at a single institution were retrospectively analyzed. Mean patient age was 69.0 ± 14.0 years old. Median follow-up was 14 months (range, 3-164 months). Anticoagulation therapy was prescribed for 6 months, followed by lifelong antiplatelet therapy. Multivariate logistic regression analysis was performed to evaluate the factors affecting the development of contralateral and ipsilateral recurrent DVT. RESULTS: Seven patients (5.4%) developed contralateral DVT (median, 26 months; range, 2-61 months), and 11 patients (8.5%) developed ipsilateral DVT (median, 1 month; range, 0-53 months). Stent location (odds ratio [OR], 11.564; 95% confidence interval [CI], 1.159-115.417) and in-stent thrombosis during follow-up (OR, 15.142; 95% CI, 1.406-163.119) were predictors of recurrent contralateral DVT. Thrombophilia (OR, 47.560; 95% CI, 2.369-954.711), remaining inferior vena cava filter (OR, 30.552; 95% CI, 3.495-267.122), and in-stent thrombosis during follow-up (OR, 82.057; 95% CI, 2.915-2309.848) were predictors of ipsilateral DVT. CONCLUSIONS: Contralateral DVT occurs late and is associated with extension of the iliac vein stent to the inferior vena cava and in-stent thrombosis. Ipsilateral DVT occurs relatively early and is associated with thrombophilia, remaining inferior vena cava filter, and in-stent thrombosis.
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