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01-04-2012 | Cardiology | Article

Interventional radiologists successfully treat post-thrombotic syndrome


Free abstract

MedWire News: Interventional radiology treatments re-establish blood flow in people with chronic deep vein thrombosis (DVT), reducing disabling symptoms and improving the quality of life for those with post-thrombotic syndrome, US research shows.

Speaking at the Society of Interventional Radiology's 37th Annual Scientific Meeting in San Francisco, California, USA, the study's lead author Mark Garcia (Christiana Care Health System, Newark, Delaware) told reporters: "The important message from our study is there is hope for those patients suffering from post-thrombotic syndrome who have been told there are no treatment options available."

Over a 3-year period, Garcia and team performed minimally invasive treatments to try and restore blood flow in 106 people with post-thrombotic syndrome caused by chronic DVT. Treatments included X-ray guided angioplasty and stenting, and catheter-guided thrombolysis.

The procedures were considered a technical success if the blocked vein could be successfully navigated and if blood flow was restored in the venous segments. Clinical success was defined as patency on ultrasound and a patient-reported improvement in symptoms. Patients were followed up at 1, 3, 6, and 12 months and yearly thereafter.

Garcia reported that successful navigation through the blocked vein occurred in 98% (120 of 122) of limbs, with blood flow restored to 97% (118 of 122).

At follow up, 93% of the individuals in the study reported significant symptomatic improvement and 7% were unchanged. None reported a worsening of symptoms.

After exclusion of patients lost to follow up, ultrasound examination demonstrated patency in 95% (95 of 100) of limbs at 1 month, 92% (71 of 77) at 3 months, 88% (57 of 65) at 6 months, 79% (30 of 38) at 12 months, and 58% (11 of 19) at 2 years. No major adverse events were noted.

"Although great strides have been made in the treatment of acute clots, there have been no real improvements in treatment strategies for chronic clot and post-thrombotic syndrome. Medical management with blood thinners and elastic compression stockings are both aimed at the prevention of symptom progression rather than resolution," said Garcia.

He continued: "This study is important because it demonstrates the ability to potentially change the way individuals with chronic deep vein thrombosis and post-thrombotic syndrome are being treated, offering them hope for a significantly improved quality of life.

"We identified a patient need and, as experts in minimally invasive techniques originally devised by our specialty, we were able to fulfill that need. We believe that being able to restore blood flow in veins previously blocked is imperative to ensuring any possibility of long-term success," he concluded.

By Laura Cowen

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