Mechanical Endovascular Thromboextraction and Catheter-Directed Thrombolysis in Patients with Iliofemoral Deep Vein Thrombosis of the Lower Extremities: a Single-Center Prospective Cohort Study

Objective. To analyze the efficacy of mechanical thromboextraction (MT) and catheter-directed thrombolysis (CDT) for deep vein thrombosis (DVT) regarding post-thrombotic syndrome (PTS) and quality of life in patients with iliofemoral DVT. Material and methods. A single-center prospective cohort study (January 2022 — June 2024) included patients with iliofemoral DVT eligible for endovascular treatment. Some patients underwent MT and/or CDT. After 6 months, we assessed severity of PTS (Villalta scale) and quality of life (SF-36 and CIVIQ-20 questionnaires). Results. Among 1908 hospitalized patients with DVT, 98 ones met the criteria for invasive treatment. The procedure was performed in 21 (21%) patients. After 6 months, PTS was less severe in patients with iliofemoral DVT who underwent MT and/or CDT compared with those who received conservative treatment alone (Villalta score 3 [2; 5] and 7 [5; 9]; p<0.001). In the invasive treatment group, 71% of patients had Villalta score < 4. In the conservative treatment group, only 9.5% of patients had score < 4. According to the SF-36 questionnaire, there were significant differences in physical health (49.7±10.7 (27—70) and 43.0±9.8 (20—61); p=0.043), while mental health was similar (53 [50; 58] and 52 [49; 55]; p=0.351). According to the CIVIQ-20 questionnaire, quality of life was significantly higher in the group of invasive treatment (85 [78; 89] and 70 [64; 78]; p=0.009). Conclusions. MT and/or CDT in iliofemoral DVT reduces the likelihood and severity of post-thrombotic syndrome, as well as contributes to better quality of life throughout 6-month follow-up.