title: Iliocaval vein stenting: Long term survey of postthrombotic symptoms and working capacity.
abstract: To evaluate the long term effect on lower extremity function and working capacity after stenting of iliocaval vein segments for acute deep venous thrombosis (DVT) or chronic venous occlusive disease. During a 14 year period from November 1994 to October 2008, 114 patients with median age 36 (interquartile range [IQR], 27-48) years, 72 (63%) women, 72 (63%) with hypercoagulable disorders, with acute DVT (n = 44, 39%), or chronic occlusions (n = 70, 61%) in the iliocaval vein segment were treated with venous stent placement after catheter-directed thrombolysis, angioplasty or recanalization. The long term impact on lower extremity function and working capacity was evaluated through retrospective evaluation of a prospectively registered database in combination with a questionnaire sent to all 108 surviving patients. The questionnaire was returned by 91/108(84%) patients, 37 (86%) with acute DVT, and 54(83%) with chronic venous occlusions. After a median follow-up of 6.2 (IQR 3.8-10.5) years, 38 (42%) patients were without anticoagulation therapy. Among patients with acute DVT 29 (78%) reported no lower extremity pain, 31 (84%) reported no ulcerations, and 26 (70%) were without lower extremity swelling, and 33(89%) without pelvic or genital pain. In summary, 22 (59%) were free from any symptomatic postthrombotic symptoms (PTS). Among patients with chronic occlusions, corresponding figures were 22 (41%), 45 (80%), 13 (24%), 39 (72%), and 7 (13%). Among patients treated for acute DVT 27 (73%) were working full- or part time, and 2 (5%) were above retirement age. Corresponding figures among patients treated for chronic venous occlusions were 31 (57%), and 10 (19%). Stenting of iliocaval vein segments with or without catheter-directed thrombolysis is a promising treatment of both acute thrombosis and chronic iliocaval vein occlusion that requires further study in comparison to non-interventional treatment concerning long time effects on postthrombotic symptoms and working capacity.
authors.affiliation: Vascular Center, Skåne University Hospital, Malmö, 205 02 Malmö, Sweden alaa.alhadad@gmail.com
authors.forename: Alaa
authors.initials: A
authors.lastname: Alhadad
authors.forename: Tilo
authors.initials: T
authors.lastname: Kölbel
authors.forename: Andreas
authors.initials: A
authors.lastname: Herbst
authors.forename: Jan
authors.initials: J
authors.lastname: Holst
authors.forename: Hussein
authors.initials: H
authors.lastname: Alhadad
authors.forename: Anders
authors.initials: A
authors.lastname: Gottsäter
mesh_terms: D000208:Acute Disease; D000328:Adult; D057785:Catheters; D002908:Chronic Disease; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D015607:Stents; D015912:Thrombolytic Therapy; D019851:Thrombophilia / Q000503:physiopathology / Q000628:therapy*; D020246:Venous Thrombosis / Q000503:physiopathology / Q000628:therapy*