Editor-in-Chief Ufuk Demirkılıç Frequency Quarterly Abbreviation Turk J Vasc Surg Publisher Turkish National Vascular and Endovascular Surgery Society ISSN 2667-4947 E-ISSN 2667-5080

Turkish Journal of Vascular Surgery 2019 , Vol 28 , Issue 3
Mid-term results of deep vein thrombosis treatment: Comparison of interventional and medical therapies
Zeynep Gülben Kük1, Kamil Boyacıoğlu2, Bülent Mert2, Adil Polat2
1Department of Cardiovascular Surgery, Tatvan State Hospital, Bitlis, Turkey
2Department of Cardiovascular Surgery, University of Health Sciences, Bağcılar Training and Research Hospital, İstanbul, Turkey
DOI : 10.9739/tjvs.2019.495 Objectives: This study aims to compare different modalities used in the treatment of deep vein thrombosis (DVT) and to identify risk factors for post-thrombotic syndrome (PTS).

Patients and methods: A total of 217 patients (119 males, 98 females; mean age 51.2±18.1 years; range, 15 to 96 years) who were treated for DVT with medical and interventional methods between August 2012 and September 2018 were retrospectively analyzed. The interventional group (Group I) consisted of 35 patients and the medical group (Group M) consisted of 182 patients. The patients were compared for risk factors, anatomic extension, and final clinical pictures.

Results: The mean follow-up was 2.6±2.5 years. Group I had more proximal involvement according to the Lower Extremity Thrombosis (LET) classification (p=0.0001). Recurrent DVT rates were 22.9% (n=8) and 13.9% (n=23) in Group I and Group M, respectively (p=0.198). The mean recurrence-free survival duration in Group I and Group M was 1.6±1.7 and 2.6±3.7 years, respectively (p=0.052). Two-year recurrence-free survival rates in Group I and Group M were 73.3±9.8% and 85.9±3.7%, respectively (p=0.479). None of the Group I patients had pulmonary embolism (PE) during follow-up. In Group M, five patients had PE (p=0.614). In the final controls, the mean Villalta scores in Group I and Group M were 3.0±2.6 and 5.4±5.2, respectively (p=0.013). The rates of patients with Villalta scores >5 were 3.4% (n=1) in Group I and 41.0% (n=32) in Group M (p=0.0001). The mean Venous Clinical Severity Scores (VCSS) were statistically significantly different in Group I and Group M (2.6±3.5 and 4.4±3.6; p=0.027). Anticoagulant-related bleeding complication rates in Group I and Group M were 27.6% (n=8) and 41.0% (n=32) (p=0.195).

Conclusion: Interventional DVT treatment results in decreased symptom severity and PTS occurrence at two years. Interventional therapy options in iliofemoral DVT offers persistent advantage in the mid-term. Keywords : Deep vein thrombosis, post-thrombotic syndrome, transcatheter thrombectomy