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CardioVascular and Interventional Radiology

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04.01.2022 | Clinical Investigation

Short- and Mid-Term Outcomes of Endovascular Stenting for the Treatment of Post-Thrombotic Syndrome due to Iliofemoral and Caval Occlusive Disease: A Multi-Centric Study from the French Society of Diagnostic and Interventional Cardiovascular Imaging (SFICV)

verfasst von: Arthur David, Frédéric Thony, Costantino Del Giudice, Gilles Goyault, Romaric Loffroy, Kévin Guillen, Yann Le Bras, Clément Marcelin, Valérie Monnin-Bares, Jean-François Heautot, Alexandre Lablee, Pierre Marek, Hervé Rousseau, Thomas Martinelli, Francine Thouveny, Pierre-Antoine Barral, Vincent Le Pennec, Pascal Chabrot, André Rogopoulos, Alicia Guillien, Marc Sapoval, Matthieu Rodière, Olivier Espitia, Frédéric Douane, For the Société Française d’Imagerie Cardiovasculaire Diagnostique et Interventionnelle

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 2/2022

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Abstract

Purpose

To assess the results of endovascular treatment in a large population of patients suffering from post-thrombotic syndrome (PTS) due to iliocaval occlusive disease.

Methods

In this retrospective multi-center study, 698 patients treated by stenting for PTS in 15 French centers were analyzed. Primary, primary assisted, and secondary patency rates were assessed, and clinical efficacy was evaluated using Villalta and Chronic Venous Insufficiency Questionnaire in 20 questions (CIVIQ-20) scores. Outcomes were compared against pre-operative CT-based severity of the post-thrombotic lesions in the thigh (4 grades).

Results

Technical success, defined as successful recanalization and stent deployment restoring rapid anterograde flow in the targeted vessel, was obtained in 668 (95.7%) patients with a complication rate of 3.9%. After a mean follow-up of 21.0 months, primary patency, primary assisted patency, and secondary patency were achieved in 537 (80.4%), 566 (84.7%), and 616 (92.2%) of the 668 patients, respectively. Venous patency was strongly correlated to the grade of post-thrombotic changes in the thigh, with secondary patency rates of 96.0%, 92.9%, 88.4%, and 78.9%, respectively, for grades 0 to 3 (p = .0008). The mean improvements of Villalta and CIVIQ-20 scores were 7.0 ± 4.7 points (p < .0001) and 19.1 ± 14.8 points (p < .0001), respectively.

Conclusion

Endovascular stenting as a treatment option for PTS due to chronic iliocaval venous occlusion generates a high technical success, low morbidity, high midterm patency rate, and clinical improvement. Venous patency was strongly correlated to the severity of post-thrombotic lesions in the thigh.

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Titel: Short- and Mid-Term Outcomes of Endovascular Stenting for the Treatment of Post-Thrombotic Syndrome due to Iliofemoral and Caval Occlusive Disease: A Multi-Centric Study from the French Society of Diagnostic and Interventional Cardiovascular Imaging (SFICV)
verfasst von: Arthur David
Frédéric Thony
Costantino Del Giudice
Gilles Goyault
Romaric Loffroy
Kévin Guillen
Yann Le Bras
Clément Marcelin
Valérie Monnin-Bares
Jean-François Heautot
Alexandre Lablee
Pierre Marek
Hervé Rousseau
Thomas Martinelli
Francine Thouveny
Pierre-Antoine Barral
Vincent Le Pennec
Pascal Chabrot
André Rogopoulos
Alicia Guillien
Marc Sapoval
Matthieu Rodière
Olivier Espitia
Frédéric Douane
For the Société Française d’Imagerie Cardiovasculaire Diagnostique et Interventionnelle
Publikationsdatum: 04.01.2022
Verlag: Springer US
Erschienen in: CardioVascular and Interventional Radiology / Ausgabe 2/2022
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-021-03038-2

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Short- and Mid-Term Outcomes of Endovascular Stenting for the Treatment of Post-Thrombotic Syndrome due to Iliofemoral and Caval Occlusive Disease: A Multi-Centric Study from the French Society of Diagnostic and Interventional Cardiovascular Imaging (SFICV)