title: Postthrombotic syndrome: feasibility of a strategy of imaging-guided endovascular intervention.
abstract: OBJECTIVE
  To describe the short-term efficacy of a strategy of imaging-guided endovascular intervention for the treatment of patients with established postthrombotic syndrome (PTS).
  
  
  METHODS
  The medical records of 183 patients with venous disease who were seen in a single interventional radiology clinic were retrospectively reviewed. Study inclusion criteria were (i) endovascular intervention performed to treat established PTS from January 1, 2000, to March 10, 2009; (ii) patient age greater than 18 years; and (iii) availability of follow-up records. A total of 44 patients (20 men, 24 women; mean age, 42.2 y ± 14.1) with PTS who had received 72 interventions (iliac vein stent placement [n = 52] and endovenous laser ablation [EVLA; n = 20]) were identified. A reviewer who did not participate in their care evaluated the follow-up records; recorded the presence or absence of pain, swelling, and active ulceration; and categorized the degree of symptom improvement.
  
  
  RESULTS
  Of 45 treated limbs in 40 patients with available follow-up, complete, partial, or no improvement of overall symptoms was observed in 46.7%, 33.3%, and 20.0%, respectively. The proportions of limbs with pain (35.0% after treatment vs 82.5% before; McNemar test, P < .01) and swelling (50.0% after treatment vs 90.0% before; P < .01) were significantly reduced after treatment with iliac vein stent placement and/or EVLA. Six of seven ulcerated limbs showed significant healing.
  
  
  CONCLUSIONS
  The use of an endovascular strategy to treat patients with established PTS was associated with complete or partial symptom relief in 80% of patients at short-term follow-up.
authors: Washington University School of Medicine, St. Louis, MO 63110, USA.
authors: Lina
authors: L
authors: Nayak
authors: Charles F
authors: CF
authors: Hildebolt
authors: Suresh
authors: S
authors: Vedantham
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D016009:Chi-Square Distribution; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D053685:Laser Therapy / Q000009:adverse effects; D007871:Leg Ulcer / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008923:Missouri; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D054070:Postthrombotic Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
chemical_list: D000925:Anticoagulants