Mechanical Thrombectomy vs. Pharmacomechanical Catheter Directed Thrombolysis for the Treatment of Iliofemoral Deep Vein Thrombosis: A Propensity Score Matched Exploratory Analysis of 12 Month Clinical Outcomes

• DOI: 10.1016/j.ejvs.2023.11.017
• Publication Date: 2023-11-21T02:02:09Z
• Authors: Steven Abramowitz; Matthew C. Bunte; Thomas S. Maldonado; Edvard Skripochnik; Sagar Gandhi; Nicolas J. Mouawad; Hamid Mojibian; Jonathan Schor; David J. Dexter; David Dexter; Robert Beasley; Adam Zybulewski; Diego Ayo; Octavio Cosme-Mon...; Christopher King; Joshua Cockrell; Jeffery Hnath; Abdullah Shaikh; Joseph Paulisin; Neil Shah; Edvard Skripochnik; Eric Trestman; Richard Schutzer; Ezana Azene; David O’Connor; Eric Trestman; Ankur Lodha; Fakhir Elmasri; Charles Moomey; Suman Annambhotla; James Nguyen; Nicolas Mouawad; Steven Abramowitz; Mohannad Bisharat; Adam Raskin; Wesley Angel; Jon Roberts; Herman Kado; Jonathan Schor; Saqib Zia; Thomas Maldonado; Eugene Ichinose; Kaylan Veerina; Sagar Gandhi; Douglas Murrey; Matthew Bunte; Bhavraj Khalsa; Matthew Jung; Daniel Long; Robert Ford; Ronald Winokur; Sonya Noor; Adam Plotnik; Jonathan Lindquist; Ambarish Bhat; Stuart Harlin; Vipul Khetarpaul; Luis Sanchez; Shuo Li; Graham Long; Hamid Mojibian
• Keywords: Post-thrombotic syndrome; Exploratory analysis

Objective Compare thrombus removal and residual venous symptoms signs of disease following interventional treatment iliofemoral deep vein thrombosis (DVT) with mechanical thrombectomy (MT) pharmacomechanical catheter directed thrombolysis (PCDT). Methods Retrospective cohort analysis propensity score matched subgroups from the multicentre prospective MT ClotTriever Outcomes registry PCDT arm randomised Acute Venous Thrombosis: Thrombus Removal Adjunctive Catheter-Directed Thrombolysis trial. Patients bilateral DVT, symptom duration greater than four weeks, isolated femoral–popliteal disease, or incomplete case data were excluded. DVT (1:1) on 10 baseline covariates, including race, sex, age, body mass index, leg treated, prior thromboembolism, Marder score, duration, provoked status, Villalta score. Reduction in post-procedure burden (i.e., scores), assessment scores) at 12 months, healthcare resource utilisation compared between subgroups. Results Propensity matching resulted 130 patient pairs no significant differences characteristics groups. was associated a reduction scores (91.0% vs. 67.7%, p < .001), proportion patients months post-thrombotic syndrome (83.1% 63.6%, = .007) receiving PCDT. No rates adjunctive stenting venoplasty identified (p .27). Higher single session seen (97.7% 26.9%, which also showed shorter mean hospital stays (1.81 3.46 overnights, less intensive care unit (2.3% 52.8%, .001). Conclusion Compared PCDT, peri-procedural reduction, more efficient care, improved months.