Abstract WP434: Incidence of Deep Venous Thrombosis Following Endovascular Revascularization via the Femoral Artery Due to Acute Ischemic Stroke

Abstract

Introduction: Deep venous thrombosis (DVT) occasionally occurs in lower extremities in stroke patients and possibly causes symptomatic venous thrombosis (VT). To prevent DVT in our stroke center, patients put on both foot pumps and elastic knee stockings after admission. However, in patients who underwent emergency endovascular revascularization via the femoral artery, DVT may often occur because of hemostasis procedures after femoral artery puncture in addition to paralysis and postoperative rest. Hypothesis: Incidence of DVT following endovascular revascularization via the femoral artery probably occurs in the femoral artery ipsilateral to femoral artery puncture. Methods: We included acute stroke patients who 1) were admitted from April 2017 to March 2019, 2) underwent emergency endovascular revascularization via the femoral artery, and 3) underwent lower extremity ultrasonography (le-US) to detect DVT during hospitalization. We investigated incidence of DVT in lower extremity with reference to our Stroke Database. Results: During study period, 56 patients met our inclusive criteria. Their median age was 78.5 years old, female gender was 34 (60.7%) and median hospital stay was 9.0 days. Le-US was conducted about 3.5 days after admission. Le-US detected DVT in 15 patients (26.8%, 15/56). Among them, 10 patients had DVT in the lower thigh vein (17.9%, 10/56) and 5 patients had DVT in the femoral vein ipsilateral to femoral artery puncture (8.9%, 5/56). Hemostasis procedures possibly induced DVT in the femoral vein, although it was uncertain whether hemostasis procedures had some relation to DVT in the lower thigh vein. No symptomatic VT occurred in the 15 patients during hospitalization. Conclusion: Incidence of DVT occurs 8.9% in the femoral vein ipsilateral to femoral artery puncture in the patients after endovascular revascularization. Some strategy is required to prevent any DVT in the femoral artery ipsilateral to femoral artery puncture.