OBJECTIVE

This study assessed the effectiveness and safety of percutaneous mechanical thrombectomy and catheter-directed thrombolysis combined with stent placement in the management of iliac vein compression syndrome with acute iliofemoral deep venous thrombosis (DVT).

METHODS

From December 2014 to April 2016, there were 46 patients with DVT who underwent percutaneous mechanical thrombectomy and catheter-directed thrombolysis and stenting for acute proximal DVT with computed tomography-verified iliofemoral stenosis. The Venous Registry Index was used for evaluating the degree of patency after pharmacomechanical thrombolysis; the prevalence of post-thrombotic syndrome (PTS) in the follow-up was assessed according to the Villalta scale. For up to 24 months, conditions of the patients were assessed using periodic duplex ultrasound scans.

RESULTS

For all patients, the technical success rate was 100%; no major bleeding or 30-day mortality was observed. Overall, the 6-, 12-, and 24-month primary patency rates were 97.8%, 95.7%, and 91.1%, respectively. There was a significant reduction in Venous Registry Index (9.82 ± 1.74 to 1.15 ± 1.02; P < .05) after the procedure. According to the Villalta score, only one patient developed mild PTS and none developed severe PTS. Symptomatic pulmonary embolism was not observed during the hospitalization. The mean hospital stay was 6.5 ± 1.7 days.

CONCLUSIONS

This technique provides a safe and effective treatment option for patients with acute proximal DVT caused by vein compression syndrome.