Endovascular treatment of acute thrombosis of the inferior vena cava is safe and effective with excellent short-term results, according to the results of a 10-year retrospective review reported by Dr. Khanjan H. Nagarsheth and his colleagues at the Staten Island University (N.Y.) Hospital.
Dr. Nagarsheth and his colleagues assessed 25 patients (44% men) with a mean age of 50.3 years, who underwent catheter-directed treatment in either the operating room or the angiography suite for acute (existing for less than 2 weeks) symptomatic IVC thrombosis (Annals Vasc Surg. 2015; 29:1373-9).
All patients had a prior history of deep vein thrombosis; 21 patients had an IVC filter at presentation.
Endovascular treatment was successful in all 25 patients. The greater majority of patients (22, 88%) received both catheter-directed thrombolysis (CDT) and pharmacomechanical thrombectomy; the remaining 3 patients received CDT alone.
Significant (greater than 50% luminal gain) angiographic resolution of the venous thromboembolism was achieved in all patients, with 23 (92%) reporting moderate to complete symptomatic improvement immediately after the procedure. At the median follow-up of 54.3 weeks, symptomatic improvement was noted in all patients, and complete symptom resolution was seen in 16 (89%). None of the IVC filters were removed and 67% of patients had a patent IVC at last follow-up.
“An aggressive endovascular approach to treatment of [acute thrombosis of the] IVC is warranted even in the presence of a thrombosed caval filter,” the authors concluded.
The authors did not indicate the existence of any conflicts.
Read the full study online in the Annals of Vascular Surgery.