Outcomes of Pharmacomechanical Catheter-directed Thrombolysis for Acute and Subacute Inferior Vena Cava Thrombosis: A Retrospective Evaluation in a Single Institution

Ye, K.; Qin, Jining; Yin, Ming; Liu, Xinyu; Lu, Xinwu

doi:10.1016/j.ejvs.2017.06.025

Cited by 17 publications

(9 citation statements)

References 37 publications

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“…18 This may result from filter obstruction by trapped or in situ thrombosis. 18 In keeping with the data obtained in our study, IVC filter placement remains the most common cause of IVC thrombosis, which compares favorably with the study by Ye et al 29 In their study, 54% (n ¼ 29/54) of patients had a history of IVC filter insertion. Current recommendations indicate that anticoagulant therapy after placement of the IVC filter should be continued until the filter is removed.…”

Section: Discussionsupporting

confidence: 91%

“…CDT or PCDT has been widely used in patients with IVC thrombosis. 1 21 29 Anticoagulant therapy remains the most important treatment for patients with IVC thrombus removal, with the aim of preventing recurrence and PTS. Given the advantages of oral administration, predictable pharmacokinetics and pharmacological characteristics, and no need for routine monitoring, traditional anticoagulants have been replaced by NOACs, of which rivaroxaban is a popular choice.…”

Section: Discussionmentioning

confidence: 99%

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Safety and Efficacy of Rivaroxaban for Inferior Vena Cava Thrombosis after Successful Catheter-Directed Thrombolysis

Nie

Yan

et al. 2021

Semin Thromb Hemost

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Rivaroxaban use for inferior vena cava (IVC) thrombosis after successful catheter-directed thrombolysis (CDT) is rarely reported. This study aimed at investigating the safety and efficacy of rivaroxaban for IVC thrombosis after CDT. The clinical data on 38 consecutive patients with IVC thrombosis (68% male; mean age, 51.5 ± 16.5), who received rivaroxaban after CDT between July 2017 and January 2020, were retrospectively analyzed in this study. Safety and efficacy of rivaroxaban (bleedings and recurrent venous thromboembolism), cumulative prevalence of post-thrombotic syndrome (PTS), primary patency, clinically driven target lesion revascularization rate, and other adverse events including all-cause mortality and vascular events (systemic embolism, acute coronary syndrome, ischemic stroke, and transient ischemic attack) were retrospectively analyzed. Of the 38 patients who received rivaroxaban for IVC thrombosis after CDT, 27 (71%) had an anticoagulant duration of 6 months and 11 patients (29%) of more than 6 months. Four patients (10%) suffered recurrent thrombosis. No patient suffered major bleeding, while clinically relevant nonmajor bleeding occurred in two (5%) patients. The cumulative prevalence of PTS was 18% (7/38) during the 12 months follow-up period. Primary patency at 1, 3, 6, and 12 months was 97, 92, 90, and 90%, respectively. According to follow-up data, the clinically driven target lesion revascularization of this study was 10%. Cardiovascular events and mortality did not occur in any patient during the study period. Rivaroxaban for IVC thrombosis after successful CDT can be safe and effective.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Rivaroxaban for Inferior Vena Cava Thrombosis after Successful Catheter-Directed Thrombolysis

Nie

Yan

et al. 2021

Semin Thromb Hemost

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“…The management of IVCT consists of in-time administration of anticoagulants, if not contraindicated. Catheter-directed thrombolysis or thrombectomy may have rapid direct thrombolytic advantages [24], while percutaneous transluminal angioplasty with a stent may also be a reasonable choice [25]. The advantage of the investigational clot-removal strategy is to reduce post-thrombotic syndrome, although it is dependent on the physician's experience.…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: A Cohort Study of Inferior Vena Cava Thrombosis in Taiwan: An Under-recognized Entity

Lin

Shen

2021

Preprint

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Background: Inferior vena cava thrombosis (IVCT) is a rare clinical condition. Herein, we report eight cases of IVCT in Taiwanese patients.Methods: Eight Taiwanese patients diagnosed with IVCT between May 2012 and December 2019 were included in this study. The patients’ demographics, presenting characteristics, additional sites of venous thromboembolism, extent of IVCT, prothrombotic risk factors, and IVCT-related adverse events were evaluated.Results: All eight patients with IVCT presented with other coexisting venous thromboembolic manifestations, such as deep venous thrombosis (DVT, 100%) or pulmonary embolism (62.5%). The clinical presentations, including DVT in both lower extremities coexisting with the dilatation of the superficial veins of the abdominal wall (50%), were reported. No congenital anomalies of the inferior vena cava (IVC) were noted. Various thromboembolic risk factors, such as unretrieved IVC filters (25%), pregnancy (37.5%), lupus anticoagulants (37.5%), surgery (25%), antithrombin deficiency (12.5%), hemoglobin H disease (12.5%), and essential thrombocythemia (12.5%), were identified. All patients were administered anticoagulants. One patient (12.5%) developed post-thrombotic syndrome. No mortality was reported in our cohort. Conclusions: This is the first report of IVCT in Taiwanese patients. Typical clinical features of IVC occlusion coexisting with predisposing factors of venous thrombosis, such as lupus anticoagulants, pregnancy, or unretrieved IVC filters, could indicate a diagnosis of IVCT. Moreover, IVCT presenting as a complication resulting from the unretrieved IVC filter was observed, highlighting the potential risks of chronic indwelling filters.

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“…Although anticoagulation treatment remains a mainstay for IVCT, endovascular techniques aimed at restoring IVC patency have become key adjunctive therapies in recent years ( 16 ). The therapy modality for IVCT should take into account the efficacy of symptom relief as well as the risk of significant PE, which need protection measures prior to future surgeries.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and a predictive model for nonfilter-associated inferior vena cava thrombosis in patients with lower extremity deep vein thrombosis

Gong

Kong

Shi

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveNonfilter-associated inferior vena cava thrombosis (IVCT) is an under-recognized but severe state of venous thromboembolism. The aims of this study were to investigate risk factors and develop a prediction model based on clinical data and imaging findings to evaluate the probability of IVCT in patients with lower extremity deep vein thrombosis (LEDVT).MethodsA single-center retrospective cohort study was conducted. We analyzed the clinical data and multimodal imaging findings of consecutive patients with confirmed LEDVT between February 2016 and January 2022. The demographics, presentation of LEDVT, laboratory examination, thrombus characteristics, comorbidities and risk factors for LEDVT, and imaging findings were analyzed using an independent t-test, Chi-square test, Fisher's exact test, and regression analysis to determine the univariable and multivariable associations and to establish a predictive model to assess the probability of IVCT.ResultsA total of 267 eligible patients were included, of whom 40 were in the IVCT group and 227 were in the non-IVCT group. The incidence of nonfilter-associated IVCT was 15.0% (40/267). Age < 63.5 years [odds ratio (OR) 2.54; 95% confidence interval (CI), 1.10–5.85, p = 0.029], male sex (OR 2.82; 95% CI, 1.19–6.72, p = 0.019), proximal DVT (OR 8.21; 95% CI, 1.01–66.76, p = 0.049), bilateral DVT (OR 7.30; 95% CI, 3.28–16.21, p < 0.001), and D-dimer >4.72 μg/ml (OR 4.64; 95% CI, 1.80–11.72, p = 0.001) were risk factors for IVCT's occurrence. Then, we established a prediction model based on these risk factors. The diagnostic efficiency [area under the curve (AUC) of receiver operating characteristic (ROC) curve was 0.858] for predicting IVCT was superior to that of isolated risk factors, including age < 63.5 years (AUC of ROC curve was 0.624) or D-dimer >4.72 μg/ml (AUC of ROC curve was 0.656).ConclusionAge < 63.5 years, male sex, proximal LEDVT, bilateral LEDVT and D-dimer >4.72 μg/ml were risk factors. The diagnostic efficiency of the predictive model for predicting IVCT was superior to that of a single risk factor alone. It may be used for predicting the probability of nonfilter-associated IVCT in patients with LEDVT.

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Outcomes of Pharmacomechanical Catheter-directed Thrombolysis for Acute and Subacute Inferior Vena Cava Thrombosis: A Retrospective Evaluation in a Single Institution

Abstract: PCDT is safe and effective in managing symptomatic acute and subacute IVC thrombosis. Active malignancy is predictor of thrombosis re-occurrence, whereas the presence of a filter is associated with a higher rate of iliocaval patency at mid-term follow-up.

Cited by 17 publications

References 37 publications

Safety and Efficacy of Rivaroxaban for Inferior Vena Cava Thrombosis after Successful Catheter-Directed Thrombolysis

Safety and Efficacy of Rivaroxaban for Inferior Vena Cava Thrombosis after Successful Catheter-Directed Thrombolysis

WITHDRAWN: A Cohort Study of Inferior Vena Cava Thrombosis in Taiwan: An Under-recognized Entity

Risk factors and a predictive model for nonfilter-associated inferior vena cava thrombosis in patients with lower extremity deep vein thrombosis

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