Postinterventional antithrombotic management after venous stenting of the iliofemoral tract in acute and chronic thrombosis: A systematic review

P. Notten, H. ten Cate, A.J. ten Cate-Hoek*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Citation (Web of Science)

Abstract

Venous stenting has become a common treatment option for central deep venous outflow obstructions and postthrombotic syndrome. Following successful recanalization and stenting, stent patency is endangered by in-stent thrombosis and recurrent venous thromboembolism. Antithrombotic therapy might reduce patency loss. This systematic review summarizes the literature on antithrombotic therapy following (post)thrombotic venous stenting. A systematic PubMed, MEDLINE, EMBASE, and Cochrane search was performed for studies addressing antithrombotic therapy prescribed following venous stenting of the iliofemoral tract indicated by acute or chronic thrombotic pathology. A total of 277 articles was identified of which 64 (56 original studies) were selected. Overall, a mean primary patency rate of 82.3% was seen 1 year after the intervention, which decreased to 73.3% after 2 years. In the majority (43 of 56 studies, 77%), treatment was based on use of vitamin K antagonists, either with (18%) or without (59%) use of antiplatelet drugs. Only two studies (4%) directly assessed the effect of antithrombotic therapy on treatment outcomes. The impact of postinterventional antithrombotic therapy on stent patency remains unknown because of limited and insufficient data available in current literature. Further clinical research should more clearly address the role of antithrombotic therapy for preservation of long-term patency following venous stenting.
Original languageEnglish
Pages (from-to)753-796
Number of pages44
JournalJournal of Thrombosis and Haemostasis
Volume19
Issue number3
DOIs
Publication statusPublished - Mar 2021

Keywords

  • antithrombotic agents
  • aspiration thrombectomy
  • catheter-directed thrombolysis
  • compression syndrome
  • deep vein thrombosis
  • deep-vein thrombosis
  • endovascular treatment
  • occlusion
  • placement
  • postthrombotic syndrome
  • therapy
  • trial
  • vascular patency
  • venous stenting
  • CATHETER-DIRECTED THROMBOLYSIS
  • DEEP-VEIN THROMBOSIS
  • POSTTHROMBOTIC SYNDROME
  • TRIAL
  • COMPRESSION SYNDROME
  • ASPIRATION THROMBECTOMY
  • THERAPY
  • PLACEMENT
  • ENDOVASCULAR TREATMENT
  • OCCLUSION

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