The prospective controlled study of stents placement in the iliac vein after catheter-directed thrombolysis in deep venous thrombosis of lower extremity

Objective To observe the efficacy of the stents placement in the iliac vein after catheter-directed thrombolysis (CDT) in deep venous thrombosis (DVT) of lower extremity. Methods This was a single-center prospective randomized controlled study. One hundred and fifty-five cases with DVT of lower extremity were treated by CDT. Then 74 patients, whose main vein distal to iliac vein completely patent and the iliac vein residual stenosis 50% were divided into control group and experimental group randomly,including 45 cases with stents placement in the experimental group and 29 cases without stent placement in the control group. The outcome measures were patency rate of deep vein, the clinical classification (C) changes of CEAP classification, changes of venous clinical severity score (VCSS), and score of chronic venous insufficiency questionnaire(CIVIQ). Results All patients were followed up with a time of 6～24 months and venography or color Doppler ultrasound examination were performed on 40 cases of the experimental group and 27 cases of the control group. There were statistical differences in the follow-up end patency rate[87.5%(35/40)vs 29.6%(8/27),P0.05],the cumulative patency rate at 1-year after procedure(86.0% vs 54.8%,P0.01),the difference of clinical classification (C) before and after procedure(1.61±0.21 vs 0.69±0.23,P0.01),the difference of VCSS before and after procedure(7.57±0.27 vs 6.56±0.23,P0.01)and the follow up end score of CIVIQ (22.67±3.01 vs 39.34±6.66,P0.01)between the experimental and control group. Conclusions The iliac vein stent implantation can improve the patency rate,efficacy,quality of life after CDT treating DVT of lower extremity.