Real clinical practice of catheter therapy for deep venous thrombosis: periprocedural and 6-month outcomes from the EDO registry.

Abstract

A recent national study in Japan indicated that 5.8% of deep venous thrombosis (DVT) patients were treated using endovascular procedures, 83% of which included catheter-directed thrombolysis (CDT). However, the details of these endovascular procedures and their outcomes have not yet been fully evaluated. Using DVT data from the EDO registry (EnDOvascular treatment registry) database, a total of 35 symptomatic iliac or femoral DVT patients who received endovascular treatment (54.3% male, age 64.7±15.1) were analyzed. The dominant patient risks were being bedridden (22.9%) and May-Thurner syndrome (25.7%). Approximately 77.1% of patients were treated using an antegrade approach, and CDT and other endovascular procedures were performed in 82.9 and 57.1% of patients, respectively. A periprocedural inferior vena cava (IVC) filter was used in 94.1% of patients, which remained implanted in 37.1 and 20.0% of patients after discharge and 6months after hospitalization, respectively. After 6months of treatment, 2.9% of patients experienced a recurrence of DVT and 5.7% suffered revascularization, but no patient had a recurrence of pulmonary embolism. Subjective symptoms improved in 80.0% of patients, while 2.9% of patients felt worse at 6months after treatment. Postthrombotic syndrome-related symptoms were observed in seven patients (19.4%), and edema was most frequently observed (71.4%). The details of CDT procedures, such as approach site and the removal of the IVC filter, varied among hospitals. Despite improved symptoms, further procedural standardization and data collection should be conducted to reduce complications and improve outcomes.