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深静脉血栓形成机械取栓术后的一年临床结局:一项CLOUT注册研究分析

One-Year Clinical Outcomes Following Mechanical Thrombectomy for Deep Vein Thrombosis: A CLOUT Registry Analysis.

作者信息

Bisharat Mohannad B, Ichinose Eugene J, Veerina Kalyan K, Khetarpaul Vipul, Azene Ezana M, Plotnik Adam N, Hnath Jeffrey, Trestman Eric, Harlin Stuart A, Bhat Ambarish, Li Shuo, Long Graham W, O'Connor David, Winokur Ronald S, Zia Saqib, Dexter David J

机构信息

HCA Florida Memorial Hospital, Jacksonville, Florida.

Oklahoma Heart Institute, Tulsa, Oklahoma.

出版信息

J Soc Cardiovasc Angiogr Interv. 2024 Feb 15;3(3Part A):101307. doi: 10.1016/j.jscai.2024.101307. eCollection 2024 Mar.

Abstract

BACKGROUND

Mechanical thrombectomy is a promising treatment option for deep vein thrombosis; however, long-term data are lacking. Here, we report for the first time the 1-year clinical outcomes from the completely enrolled ClotTriever Outcomes (CLOUT) registry evaluating mechanical thrombectomy with the ClotTriever System (Inari Medical).

METHODS

The CLOUT registry (NCT03575364) is a prospective, multicenter, single-arm study that enrolled 500 patients with proximal lower extremity deep vein thrombosis. Prespecified 1-year outcomes include Villalta score and corresponding postthrombotic syndrome (PTS) severity, duplex ultrasound findings of patency (defined as the presence of flow with normal or partial compressibility), Revised Venous Clinical Severity Score, and quality of life (QoL).

RESULTS

In CLOUT, the median age was 61.9 years and 50.5% of patients were women. A total of 310 patients completed the 1-year visit. The 1-year PTS rate (Villalta score ≥ 5) was 19.3% and the moderate-to-severe PTS rate (Villalta score ≥ 10) was 8.8%. Median Villalta score decreased from 9.0 (IQR, 5.0-14.0) at baseline to 1.0 (IQR, 0.0-4.0) at 1 year ( < .0001). Similar rates of PTS and moderate-to-severe PTS were observed among limbs assessed at all study time points. Patency was observed in 94.2% of limbs. Median Revised Venous Clinical Severity Score was 6.0 (IQR, 3.0-9.0) at baseline and 3.0 (IQR, 1.0-4.0) at 1 year ( < .0001). Additionally, 90.4% of patients experienced improvements in QoL.

CONCLUSIONS

One-year outcomes from the CLOUT registry demonstrate low PTS rates and preserved patency accompanied by improved symptom relief and QoL. Study follow-up through 2 years is ongoing.

摘要

背景

机械血栓切除术是治疗深静脉血栓形成的一种有前景的治疗选择;然而,缺乏长期数据。在此,我们首次报告了完全入组的ClotTriever结局(CLOUT)注册研究的1年临床结局,该研究评估了使用ClotTriever系统(Inari Medical公司)进行的机械血栓切除术。

方法

CLOUT注册研究(NCT03575364)是一项前瞻性、多中心、单臂研究,纳入了500例下肢近端深静脉血栓形成患者。预先设定的1年结局包括Villalta评分及相应的血栓形成后综合征(PTS)严重程度、通畅性的双功超声检查结果(定义为存在血流且具有正常或部分可压缩性)、修订的静脉临床严重程度评分以及生活质量(QoL)。

结果

在CLOUT研究中,中位年龄为61.9岁,50.5%的患者为女性。共有310例患者完成了1年随访。1年PTS发生率(Villalta评分≥5)为19.3%,中重度PTS发生率(Villalta评分≥10)为8.8%。Villalta评分中位数从基线时的9.0(四分位间距,5.0 - 14.0)降至1年时的1.0(四分位间距,0.0 - 4.0)(P <.0001)。在所有研究时间点评估的肢体中,观察到的PTS和中重度PTS发生率相似。94.2%的肢体观察到通畅。修订的静脉临床严重程度评分中位数在基线时为6.0(四分位间距,3.0 - 9.0),在1年时为3.0(四分位间距,1.0 - 4.0)(P <.0001)。此外,90.4%的患者生活质量得到改善。

结论

CLOUT注册研究的1年结局显示PTS发生率低且通畅性良好,同时症状缓解和生活质量得到改善。正在进行为期2年的研究随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc96/11308810/cec1cf07f062/gr6.jpg

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