Outcomes of Profunda Femoris Vein Thrombosis Evaluation and Clearance by Percutaneous Mechanical Thrombectomy for Acute Iliofemoral Deep Vein Thrombosis.

Abstract

This study aimed to investigate the outcomes of profunda femoris vein thrombosis evaluation and clearance (PFV-TEC) by percutaneous mechanical thrombectomy (PMT) for acute iliofemoral deep vein thrombosis (DVT). This study retrospectively analysed data from the CODA study (NCT06124768) from January 2021 to December 2022. Consecutive patients with acute iliofemoral DVT treated by PMT were included. Patients were categorised into two treatment groups: PMT with PFV-TEC and PMT without PFV-TEC. The primary efficacy outcome was the 24 month incidence of post-thrombotic syndrome (PTS). Ninety-three patients were included: 43 patients underwent PMT with PFV-TEC and 50 patients without PFV-TEC. In the PMT with PFV-TEC group, 39 patients had profunda femoris vein (PFV) thrombosis and successfully underwent PMT. The 24 month iliofemoral vein and PFV patency rates were 90% and 89% in the PMT with PFV-TEC group, which were statistically significantly higher than those in the PMT without PFV-TEC group (p = .033 and p = .001, respectively). The 24 month incidence of PTS was statistically significantly lower in the PMT with PFV-TEC group than in the PMT without PFV-TEC group (11% vs. 32%; p = .020). Multivariable analysis identified iliofemoral vein patency (hazard ratio [HR] 0.07, 95% confidence interval [CI] 0.02 - 0.38; p = .002) and PFV patency (HR 0.07, 95% CI 0.01 - 0.61; p = .017) as independent protective factors against PTS. PMT with PFV-TEC improved iliofemoral and PFV patency and decreased the incidence of PTS. PFV-TEC is recommended in PMT treatment for acute iliofemoral DVT.