Khider Lina, Del Giudice Costantino, Gendron Nicolas, Gobert Chloé, Planquette Benjamin, Al Ahmar Marc, Goudot Guillaume, Messas Emmanuel, Sapoval Marc, Mirault Tristan
Paris Cité University, INSERM, Paris Cardiovascular Research Centre, Team Endotheliopathy and Hemostasis Disorders, Paris, France; Vascular Medicine Department, Assistance Publique Hôpitaux de Paris Centre-Université de Paris (APHP-CUP), Paris, France.
Interventional Radiology, Assistance Publique Hôpitaux de Paris Centre-Université de Paris (APHP-CUP), Paris, France.
J Vasc Surg Venous Lymphat Disord. 2025 Jul 11;13(6):102287. doi: 10.1016/j.jvsv.2025.102287.
Endovascular recanalization is considered for severely symptomatic patients with post-thrombotic syndrome (PTS) to alleviate symptoms. However, data on complete recovery and its predictors remain limited. This study aimed to assess persistent PTS 6 months after venous recanalization and identify predictive factors.
Single-center retrospective outcome-oriented cohort study.
We reviewed electronic medical records of patients referred for endovascular venous recanalization between January 1, 2015, and September 30, 2019. Inclusion criteria were PTS defined by a Villalta score of ≥5 or a leg ulcer ≥6 months after a deep vein thrombosis episode. Complete PTS recovery was defined as a Villalta score of <5.
Sixty-seven patients (median age, 40 years; interquartile range, 32-51 years; 78% women; 18% obese) were included. The initial Villalta score was 10 (interquartile range, 7-14). At 6 months, primary and secondary patency rates were 75% and 81%, respectively. Complete recovery was observed in 67% of patients. Multivariate analysis identified the initial Villalta score (odds ratio, 1.36; 95% confidence interval, 1.12-1.65; P = .002) and femoral vein obstruction (odds ratio, 3.79; 95% confidence interval, 1.06-13.61; P = .041) as predictors of persistent PTS, whereas long-term anticoagulation was not significant.
Endovascular recanalization achieved PTS resolution in two-thirds of patients at 6 months, particularly in those with a low initial Villalta score and no femoral vein obstruction. A risk score incorporating these factors may aid clinicians in patient counseling regarding the expected benefits of the procedure.
对于有严重症状的血栓后综合征（PTS）患者，可考虑进行血管内再通术以缓解症状。然而，关于完全恢复及其预测因素的数据仍然有限。本研究旨在评估静脉再通术后6个月时持续存在的PTS情况，并确定预测因素。
单中心回顾性以结果为导向的队列研究。
我们回顾了2015年1月1日至2019年9月30日期间因血管内静脉再通术而转诊患者的电子病历。纳入标准为深静脉血栓形成发作后Villalta评分≥5或腿部溃疡≥6个月所定义的PTS。完全PTS恢复定义为Villalta评分<5。
纳入67例患者（中位年龄40岁；四分位间距32 - 51岁；78%为女性；18%为肥胖患者）。初始Villalta评分为10（四分位间距7 - 14）。在6个月时，原发性和继发性通畅率分别为75%和81%。67%的患者观察到完全恢复。多变量分析确定初始Villalta评分（比值比，1.36；95%置信区间，1.12 - 1.65；P = 0.002）和股静脉阻塞（比值比，3.79；95%置信区间，1.
06 - 13.61；P = 0.041）为持续PTS的预测因素，而长期抗凝并不显著。
血管内再通术在6个月时使三分之二的患者PTS得到缓解，特别是那些初始Villalta评分低且无股静脉阻塞的患者。纳入这些因素的风险评分可能有助于临床医生在向患者咨询该手术预期益处时提供参考。
