Interventional treatment of postthrombotic syndrome

• Published in: Gefässchirurgie Vol. 21; no. Suppl 2; pp. 37 - 44
• Main Authors: Jalaie, H., Schleimer, K., Barbati, M. E., Gombert, A., Grommes, J., de Wolf, M. A. F., de Graaf, R., Wittens, C. H. A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 2016
• Subjects: Leitthema; Medicine; Medicine & Public Health; Vascular Surgery; Postthrombotic syndrome; Venöse Rekanalisation; Venous recanalization; Postthrombotisches Syndrom; Venöse Stents; Chronic venous obstruction; Endophlebectomy; Endophlebektomie; Venous stents; Chronisch-venöse Obstruktion
• ISSN: 0948-7034; 1434-3932
• DOI: 10.1007/s00772-016-0156-4

Background Postthrombotic syndrome (PTS) is the development of symptoms and signs of chronic venous insufficiency following deep vein thrombosis (DVT) and has a significant negative effect on the quality of life. The current understanding is that the clinical manifestation of PTS is related more to venous obstruction than it is to venous reflux. The use of interventional techniques for the treatment of venous obstruction and/or venous occlusion has rapidly increased in recent years. Objective This article summarizes the current concept of endovenous and hybrid interventions and presents the optimized treatment of choice in patients with chronic symptomatic venous obstruction. Methods We performed a systematic literature search in the Medline database to identify relevant studies on the treatment of patients with PTS. Results A meta-analysis of the relevant studies showed that this minimally invasive procedure is an effective treatment option with low morbidity and no mortality. Use of the newly developed dedicated venous stents showed promising results with good mid-term patency rates and a significant decrease in related symptoms. Conclusion Interventional therapy for the treatment of symptomatic chronic venous obstruction has become the method of choice in recent years. More studies are needed to evaluate the long-term success rate of dedicated venous stents.