Lina Nayak BA, Presenter: Nothing to Disclose

Suresh Vedantham MD, Abstract Co-Author: Research support, Covidien AG Research support, Bayer AG Research support, Genentech, Inc Research support, BSN medical GmbH

Post-Thrombotic Syndrome (PTS) is a frequent cause of chronic pain, swelling, and disability in patients with deep vein thrombosis, and currently has no consistently effective treatment. The purpose of this study is to describe the feasibility of and initial clinical response to a strategy of imaging-guided endovascular intervention for the treatment of established PTS.

The medical records of 183 venous disease patients who were seen in our Interventional Radiology clinic were retrospectively reviewed. Study inclusion criteria were: endovascular intervention performed to treat established PTS from 1/1/2000 to 3/10/2009, patient age 18 years or greater at the time of intervention, and availability of follow-up clinical records. A total of 44 adults (20 men and 24 women, mean age 42.2 (range 20-77) years) with PTS who received a total of 72 interventions (iliac vein stent placement [n=52] or endovenous thermal ablation [n=20]) were identified. A reviewer who did not participate in the patients’ care evaluated the follow-up records documenting the physician-adjudicated clinical response observed 1-3 months post-intervention, and retrospectively categorized the degree of symptom improvement as being complete or near-complete, partial, or none.

Four patients were lost to follow-up. Of the remaining 40 patients, the rates of complete, partial, and no improvement of overall symptoms after completion of the final (or only) intervention were 45%, 35%, and 20%, respectively. Of the 34 patients with pain, the rates of complete, partial, and no improvement of pain were 61.8%, 14.7%, and 23.5%, respectively. Of the 36 patients with swelling, the rates of complete, partial, and no improvement of swelling were 47.2%, 27.8%, and 25.0%, respectively. Of the 6 patients with ulceration, the rates of complete, partial, and no ulcer healing were 66.7%, 16.7%, and 16.7%, respectively.  

In a preliminary study, the use of stent placement and endovenous thermal ablation to treat established PTS was feasible and was associated with complete or partial initial symptom improvement in 80% of patients.

Imaging-guided endovascular interventions (stent placement and endovenous thermal ablation) can provide symptomatic relief in patients with established Post-Thrombotic Syndrome.

Nayak, L, Vedantham, S, Post-Thrombotic Syndrome: Early Outcomes of Imaging-guided Endovascular Intervention.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9001889.html