Faculty Collaboration Database

Antithrombotic management of patients with deep vein thrombosis and venous stents: an international registry. J Thromb Haemost 2023 Dec;21(12):3581-3588

Date

09/23/2023

Pubmed ID

37739038

DOI

10.1016/j.jtha.2023.09.008

Scopus ID

2-s2.0-85174802544 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

BACKGROUND: In patients with acute deep vein thrombosis (DVT) treated with catheter-based thrombolysis and venous stenting, poststenting anticoagulant management is uncertain.

OBJECTIVES: To determine the type and duration of antithrombotic therapy used in patients who have received venous stents for treatment of acute lower extremity DVT.

METHODS: We created an international registry of patients with leg DVT from 2005 to 2019 who received venous stents as part of their acute management. We collected data on baseline clinical characteristics and pre-venous and post-venous stent antithrombotic therapy.

RESULTS: We studied 173 patients with venous stents: 101 (58%) were aged ≤50 years, 105 (61%) were female, and 128 (74%) had risk factors for thrombotic disease. DVT was iliofemoral in 150 (87%) patients, and catheter-based treatment was given within 7 days of diagnosis in 92 (53%) patients. After venous stenting, 109 (63%) patients received anticoagulant-only therapy with a direct oral anticoagulant (29%), warfarin (22%), or low-molecular-weight heparin (10%), and 59 (34%) received anticoagulant-antiplatelet therapy. In patients taking anticoagulant-only therapy, 29% received indefinite treatment; in patients on anticoagulant-antiplatelet therapy, 19% received indefinite treatment. Factors associated with combined anticoagulant-antiplatelet therapy vs anticoagulant-only therapy were use of thrombolytic, thrombectomy, and aspiration interventions (odds ratio [OR], 5.11; 95% CI, 1.45-18.05); use of balloon angioplasty (OR, 2.62; 95% CI, 1.20-5.76); and immediate stent restenosis (OR, 7.2; 95% CI, 1.45-5.89).

CONCLUSION: Anticoagulant therapy without concomitant antiplatelet therapy appears to be the most common antithrombotic strategy in patients with DVT and venous stenting. More research is needed to determine outcomes of venous stenting in relation to antithrombotic therapy.

Author List

Lee Cervi A, Applegate D, Stevens SM, Woller SC, Baumann Kreuziger LM, Punchhalapalli K, Wang TF, Lecumberri R, Greco K, Bai Y, Bolger S, Fontyn S, Schulman S, Foster G, Douketis JD

Author

Lisa M. Baumann Kreuziger MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anticoagulants
Female
Femoral Vein
Fibrinolytic Agents
Humans
Male
Platelet Aggregation Inhibitors
Retrospective Studies
Stents
Thrombolytic Therapy
Treatment Outcome
Venous Thrombosis