Endovascular Treatment of Post-thrombotic Venous Ilio-Femoral Occlusions: Prognostic Value of Venous Lesions Caudal to the Common Femoral Vein.
OBJECTIVES
To propose a scale of severity for post-thrombotic venous lesions (PTVLs) after ilio-femoral deep venous thrombosis and to compare the grade with the results of endovascular treatment of ilio-femoral PTVLs.


METHODS
In this retrospective monocentric observational study, we included 95 patients treated for ilio-femoral PTVLs. We proposed a four-grade scale evaluating the severity of PTVLS caudal to the common femoral vein based on CT phlebography and per-operative phlebography. For most patients, venous patency was assessed with color duplex ultrasonography and the clinical efficacy of the intervention using the Villalta and CIVIQ scores.


RESULTS
Recanalization was successful in 100% of patients with a morbidity rate of 4%. After a mean follow-up of 21 months, the overall primary patency was 75%, the assisted primary patency 82%, and the secondary patency 93%. Secondary patency was 100% for grade 0-1, 90% for grade 2, and 63% for grade 3 (p < 0.002). There was no correlation between the extension of stenting caudally of the common femoral vein and venous patency. The mean improvements in the Villalta and CIVIQ-20 scores were, respectively, 4.6 (p < 0.0001) and 18 (p < 0.0001); scores were not correlated with the grade of PTVLs in the thigh.


CONCLUSION
Venous patency after endovascular treatment of ilio-femoral PTVLs was strongly linked to the severity of PTVLs caudal to the common femoral vein but not to the extent of stenting.
['Menez|Caroline|C|', 'Rodiere|Mathieu|M|', 'Ghelfi|Julien|J|', 'Seinturier|Christophe|C|', 'Martinelli|Thomas|T|', 'Imbert|Bernard|B|', 'Perolat|Romain|R|', 'Bouzat|Pierre|P|', 'Blaise|Sophie|S|', 'Carpentier|Patrick|P|', 'Pernod|Gilles|G|', 'Thony|Frédéric|F|http://orcid.org/0000-0002-7102-7169']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D001157:Arterial Occlusive Diseases D057510:Endovascular Procedures D005260:Female D005268:Femoral Vein D006801:Humans D007084:Iliac Vein D008297:Male D008875:Middle Aged D054070:Postthrombotic Syndrome D011379:Prognosis D012189:Retrospective Studies D016896:Treatment Outcome D018615:Ultrasonography, Doppler, Color D055815:Young Adult
Deep venous thrombosis Stent Iliac vein Inferior vena cava Post-thrombotic syndrome