Vasc Spec Int.  2018 Jun;34(2):26-30. 10.5758/vsi.2018.34.2.26.

Does Catheter-Directed Thrombolysis Prevent Postthrombotic Syndrome?

• Kim YA
• Yang SS
• Yun WS

• KMID: 2416377
• DOI: http://doi.org/10.5758/vsi.2018.34.2.26

Abstract

PURPOSE
The aim of this study is to identify risk factors of postthrombotic syndrome (PTS) and evaluate the efficacy of catheter-directed thrombolysis (CDT) for preventing the development of PTS in patients with lower extremity deep vein thrombosis (DVT).
MATERIALS AND METHODS
From 2005 January to 2013 December, 139 limbs of 126 patients were included in this study who had the first episode of proximal DVT at the affected limb and who had visited our out-patient clinic. CDT was performed on 55 limbs (39.6%). We achieved complete recanalization in 39 limbs (70.9%) and partial recanalization (residual thrombus < 50.0%) in 16 limbs (29.1%). We retrospectively reviewed medical records for possible predictors of PTS.
RESULTS
Median follow-up duration was 83 months (range, 30-136 months). No differences were found between the CDT and non-CDT group in age, gender, duration of symptom, use of anticoagulation and recurrence of DVT. A significantly higher thrombotic burden was observed in the CDT group (P=0.009). In a binary logistic regression model, patients with PTS had significantly higher body mass index (BMI) (odds ratio [OR], 1.303; 95% confidence interval [CI], 1.079-1.574; P=0.006) and longer thrombotic burden involved in ilio-femoro-popliteal DVT (OR, 3.666; 95% CI, 1.093-12.296; P=0.035). CDT did not influence the risk of PTS (P>0.05).
CONCLUSION
We suggest that CDT is not effective in preventing PTS, while higher BMI and longer thrombotic burden are associated with the development of PTS in patients with DVT.

Keyword

Postthrombotic syndrome; Catheter directed thrombolysis; Venous thrombosis

MeSH Terms

Body Mass Index
Extremities
Follow-Up Studies
Humans
Logistic Models
Lower Extremity
Medical Records
Outpatients
Postthrombotic Syndrome*
Recurrence
Retrospective Studies
Risk Factors
Thrombosis
Venous Thrombosis