Anja B. Drebes* and Neil H. Davies
In recent years there has been an increasing interest in endovascular iliofemoral vein stenting to prevent/alleviate symptoms relating to proximal venous outflow obstruction. Maintaining long-term stent patency is one of the main challenges, and risk factors for the development of re-thrombosis are not well understood. Published data on safety and efficacy of the procedure predominantly comes from cohort studies mainly focusing on mechanical aspects relating to stent placement and flow. Aetiology of thrombus formation and thrombotic tendencies of patients due to underlying medical conditions are not captured well or linked to clinical outcomes, and impact of choice and length of antithrombotic therapy have not been specifically investigated. Here we review different procedure-related factors and patient characteristics that might increase the risk of re-thrombosis and the utility of antithrombotic treatment options currently available.
(venous stent, anticoagulation, iliofemoral vein thrombosis, direct oral anticoagulants, postthrombotic syndrome)
KD Haemophilia and Thrombosis Centre, Royal Free London NHS Foundation Trust, Department of Interventional Radiology, Royal Free London NHS Foundation Trust