Journals / Turkish journal of vascular surgery / 2019 / Cilt: 28 - Sayı: 3
Mid-term results of deep vein thrombosis treatment: Comparison of interventional and medical therapies
- Pages
- 165–173
- DOI
- —
Özet
Objectives: This study aims to compare different modalities used in the treatment of deep vein thrombosis (DVT) and to identify riskfactors 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 forDVT with medical and interventional methods between August 2012 and September 2018 were retrospectively analyzed. The interventionalgroup (Group I) consisted of 35 patients and the medical group (Group M) consisted of 182 patients. The patients were compared for riskfactors, 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-yearrecurrence-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 patientshad pulmonary embolism (PE) during follow-up. In Group M, five patients had PE (p=0.614). In the final controls, the mean Villalta scoresin 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 significantlydifferent 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 GroupM 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 therapyoptions in iliofemoral DVT offers persistent advantage in the mid-term.