Scholarlink

Background <p><?tk 4?>Acute iliofemoral deep vein thrombosis (IFDVT) often leads to femoral vein valve incompetence and post-thrombotic syndrome (PTS). This study evaluated whether thrombus volume reduction surgery (TVRS) is associated with better valve function preservation compared with simple anticoagulation (SA) in patients with acute IFDVT.</p> Methods <p>A combined retrospective and prospective cohort study involving 504 patients with acute IFDVT compared TVRS (<i>n</i> = 238) and SA (<i>n</i> = 266). The primary outcome was the femoral vein valve preservation rate at 12 months. Secondary outcomes included PTS incidence and quality of life. Subgroup analysis compared two pharmacomechanical thrombectomy devices: AngioJet and Acostream. Propensity score matching (1:1 nearest neighbor, caliper 0.05), inverse probability of treatment weighting, and E-value sensitivity analysis were employed to address confounding. An exploratory mediation analysis (hypothesis-generating) examined whether valve preservation potentially mediates the association between TVRS and PTS reduction.</p> Results <p>The TVRS group showed a significantly higher valve preservation rate (75.8% vs. 43.9%, <i>P</i> &lt; 0.001) and a lower incidence of moderate-to-severe PTS (13.6% vs. 34.8%, <i>P</i> = 0.002) compared with the SA group. TVRS patients also achieved better quality of life scores with comparable safety profiles. In a pre-specified, exploratory subgroup analysis of patients who underwent PMT with complete ultrasound follow-up data (<i>n</i> = 50 per device), AngioJet appeared to be associated with a higher valve preservation rate compared with Acostream (82% vs. 70%, <i>P</i> = 0.04), although this comparison was underpowered, non-randomized, and should be considered strictly hypothesis-generating.</p> Conclusions <p>TVRS was associated with improved femoral vein valve preservation, lower PTS incidence, and enhanced quality of life compared with SA. The AngioJet system may be associated with better valve protection than the Acostream system, but this finding is exploratory and requires validation in randomized trials. These observations support the hypothesis that early thrombectomy intervention may be beneficial for long-term venous function, but cannot establish causality.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Thrombectomy reduces femoral vein valve damage after acute iliofemoral vein thrombosis: a combined retrospective and prospective cohort study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月24日

查看全文
  • Yanyang Wang,
  • Yaoguo Yang,
  • Sheng Wang,
  • Liang Zhao,
  • Jie Zhang,
  • Zhong Chen

摘要

Background

Acute iliofemoral deep vein thrombosis (IFDVT) often leads to femoral vein valve incompetence and post-thrombotic syndrome (PTS). This study evaluated whether thrombus volume reduction surgery (TVRS) is associated with better valve function preservation compared with simple anticoagulation (SA) in patients with acute IFDVT.

Methods

A combined retrospective and prospective cohort study involving 504 patients with acute IFDVT compared TVRS (n = 238) and SA (n = 266). The primary outcome was the femoral vein valve preservation rate at 12 months. Secondary outcomes included PTS incidence and quality of life. Subgroup analysis compared two pharmacomechanical thrombectomy devices: AngioJet and Acostream. Propensity score matching (1:1 nearest neighbor, caliper 0.05), inverse probability of treatment weighting, and E-value sensitivity analysis were employed to address confounding. An exploratory mediation analysis (hypothesis-generating) examined whether valve preservation potentially mediates the association between TVRS and PTS reduction.

Results

The TVRS group showed a significantly higher valve preservation rate (75.8% vs. 43.9%, P < 0.001) and a lower incidence of moderate-to-severe PTS (13.6% vs. 34.8%, P = 0.002) compared with the SA group. TVRS patients also achieved better quality of life scores with comparable safety profiles. In a pre-specified, exploratory subgroup analysis of patients who underwent PMT with complete ultrasound follow-up data (n = 50 per device), AngioJet appeared to be associated with a higher valve preservation rate compared with Acostream (82% vs. 70%, P = 0.04), although this comparison was underpowered, non-randomized, and should be considered strictly hypothesis-generating.

Conclusions

TVRS was associated with improved femoral vein valve preservation, lower PTS incidence, and enhanced quality of life compared with SA. The AngioJet system may be associated with better valve protection than the Acostream system, but this finding is exploratory and requires validation in randomized trials. These observations support the hypothesis that early thrombectomy intervention may be beneficial for long-term venous function, but cannot establish causality.