Skip to main content
VENOUS2024 Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Break in Exhibit Hall & Posters in Foyer

Break in Exhibit Hall & Posters in Foyer

Antiplatelet and Anticoagulant Regimen Post Iliac Vein Stenting

Tuesday, March 5, 2024
3:15 PM – 4:45 PM EST
Location: Foyer
Objective: Iliac vein compression often leads to acute or chronic deep vein thrombosis (DVT).  Most patients with a history of iliofemoral DVT develop symptoms of post-thrombotic syndrome such as swelling, pain, ulceration, and claudication of lower extremities. The Society of Vascular Surgery recommends iliac venous stenting to treat iliofemoral DVT in the context of compression, however, there is minimal consensus on optimal post-intervention management. This study aims to shed light on the impact of antiplatelet and anticoagulation regimens on the outcomes of iliofemoral vein stenting.

Methods: We conducted a retrospective analysis of patients who underwent iliac vein stenting for thrombosis between 2010 and 2022 within our institution. The anticoagulation and antiplatelet therapies prescribed at discharge were recorded. Treatments were classified as anticoagulant (AC), antiplatelet (AP), antiplatelet and anticoagulant (AP+AC). We stratified the cohort by acute and chronic lesions. We observed the effects of each of these groups, and then analyzed the data by isolating the effect of AP and AC. Primary outcomes were DVT recurrence and stent patency. We performed two multivariable logistic regressions for each outcome: the first model accounted for acute and chronic status of the DVT, and the second also accounted for sex, race, smoking status, and prior DVT or PE. We did not include age and BMI due to multicollinearity. Two models were used, as our second model had a smaller sample size.

Results:

We identified 128 patients who underwent iliac vein stenting for acute or chronic DVT. Immediate post-operative treatment included 13 (10.1%)  patients who received AP only, 34 (26.5%)  received AC only, and 70 (54.7%) received AP+AC. 89 (69.5%) patients presented with acute DVT, and 39 (30.4%) patients had chronic DVT. 


In our first model, we observed a significant difference when patients received AP+AC for DVT recurrence. There was not a significant difference between AP, AC and AP+AC for stent patency. 

When we added the history of DVT/PE into the second model, along with other variables, we did not note any significant differences for either outcome, as the effect was absorbed (Table I). However, we noted that prior DVT had significant correlation within DVT recurrence. 

Conclusions: Dual therapy with antiplatelets and anticoagulants may be correlated with improved outcomes for iliac vein stenting, namely for preventing DVT recurrence. Greater sample size and further characterization of medical history with hypercoagulable disorders may illuminate the correlation between medication regimen and outcomes more granularly.