Impact of concomitant popliteal vein thrombosis in patients with acute iliofemoral deep vein thrombosis treated with endovascular early thrombus removal.

Frey, Vincent; Sebastian, Tim; Barco, Stefano; Spirk, David; Hayoz, Daniel; Périard, Daniel; Kucher, Nils; Betticher, Daniel; Engelberger, Rolf P (2022). Impact of concomitant popliteal vein thrombosis in patients with acute iliofemoral deep vein thrombosis treated with endovascular early thrombus removal. Vasa : European journal of vascular medicine, 51(5), pp. 282-290. Hogrefe 10.1024/0301-1526/a001017

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Background: Catheter-based thrombus removal (CBTR) reduces the risk of moderate to severe post-thrombotic syndrome (PTS) in patients with acute iliofemoral deep vein thrombosis (IF-DVT). However, the impact of concomitant popliteal DVT on clinical and duplex sonographic outcomes is unknown. Patients and methods: In this post-hoc analysis including the entire cohort of the randomized controlled BERNUTIFUL trial (48 patients), we compared clinical (incidence/severity of PTS assessed by Villalta score and revised venous clinical severity scores, rVCSS), disease-specific quality-of-life (QOL, CIVIQ-20 survey) and duplex sonographic outcomes (patency, reflux, post-thrombotic lesions) at 12 months follow-up between patients with IF-DVT with and without concomitant popliteal DVT treated by CBTR. Results: Overall, 48 IF-DVT patients were included (48% men, median age of 50 years), of whom 17 (35%) presented with popliteal DVT. At baseline, patients with popliteal DVT were older, had a higher body mass index and more important leg swelling. At 12 months, freedom from PTS (93% vs 87%, P=0.17), median total Villalta score (1 vs 1.5; P=0.46), rVCSS (2 vs 1.5, P=0.5) and disease-specific QOL (24 points vs 24 points, P=0.72) were similar between patient with and without popliteal DVT, respectively. Duplex sonographic outcomes were similar, except for more frequent popliteal post-thrombotic lesions and reflux (P=0.02) in patients with popliteal DVT. Conclusions: Relevant clinical outcomes 1 year after successful CBTR were favorable, regardless of the presence or absence of concomitant popliteal DVT. However, post-thrombotic popliteal vein lesions and reflux are more frequent in IF-DVT patients with popliteal involvement. Their impact on long-term outcomes remains to be investigated.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Pharmacology
UniBE Contributor:	Spirk, David
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0301-1526
Publisher:	Hogrefe
Language:	English
Submitter:	Pubmed Import
Date Deposited:	04 Jul 2022 08:08
Last Modified:	05 Dec 2022 16:21
Publisher DOI:	10.1024/0301-1526/a001017
PubMed ID:	35774017
Uncontrolled Keywords:	Iliofemoral deep vein thrombosis popliteal vein thrombosis post-thrombotic syndrome thrombolytic therapy thrombosis
URI:	https://boris.unibe.ch/id/eprint/171053