麻豆传媒

SAN FRANCISCO -- Minimally invasive procedures such as angioplasty and stenting may alleviate symptoms of chronic deep vein thrombosis (DVT), researchers said here.

In a single-center, retrospective study, 93% of patients reported significant improvement in symptoms over a mean follow-up of about two and a half years, Mark Garcia, MD, of Christiana Care Health System in Newark, Del., and colleagues reported during a press briefing at the Society of Interventional Radiology meeting here.

Garcia said it represents an "aggressive" approach to managing this disease, which is typically treated with oral anticoagulation and compression stockings.

He added that it may eventually lead to a new management strategy for this condition and for its major complication, post-thrombotic syndrome.

Few studies have assessed the effects of endovascular treatment for chronic DVT, Garcia said. At the same time, he added, there hasn't been much by way of new therapies for the condition, even though there have been a number of successes for treating acute DVT.

So he and his colleagues conducted a retrospective registry study of patients treated with a host of endovascular therapies for these diseases at their institution, including angioplasty, stenting, and thrombolytic therapy.

The study included a total of 106 patients -- 66 men, 40 women, mean age 57 -- who had 122 limbs treated; 17 were upper-limb extremities and 105 were lower-limb extremities.

All had DVT symptoms for at least one month, and all had various degrees of symptoms of post-thrombotic syndrome, including pain and swelling.

Garcia and colleagues found that clinicians were able to successfully navigate through the blocked vein in 98% of cases, and they were able to restore blood flow in 97% of cases.

During a mean follow-up of two years, 18 limbs were lost to follow-up, but 93% of the remaining patients reported significant improvement in symptoms.

For patients who had follow-up ultrasound, 88% of veins remained open at six months, 79% remained open at one year, and 58% still had good blood flow at two years, even though only 19 patients were imaged at that time.

Garcia said the therapy may even be effective in veins that were occluded years ago, giving an example of a 65-year-old female patient who'd had an vein surgically occluded during a hysterectomy 10 years prior to having an endovascular procedure.

She had restored blood flow during one year of follow-up and reported significant symptom improvement, he said.

Suresh Vendantham, MD, of Washington University in St. Louis, Mo., who moderated the press conference, said being able to treat patients late could be important for those who can't have these therapies initially because of other medical conditions.

"If you can treat the patient later on when they're in better shape, that could be very impactful," he said during the briefing.

Garcia called for larger randomized, controlled trials to determine whether these treatments are effective and if they hold any advantages over standard management with oral anticoagulation and compression stockings.

From the American Heart Association:

Comment