Antithrombotic management of patients with deep vein thrombosis and venous stents: an international registry

Background: In patients with acute deep vein thrombosis (DVT) treated with catheterbased thrombolysis and venous stenting, poststenting anticoagulant management is uncertain. Objectives: To determine the type and duration of antithrombotic therapy used in patients who have received venous stents for treatment of acute lower extremity DVT.Methods: We created an international registry of patients with leg DVT from 2005 to 2019 who received venous stents as part of their acute management. We collected data on baseline clinical characteristics and pre-venous and post-venous stent antithrombotic therapy.Results: We studied 173 patients with venous stents: 101 (58%) were aged <= 50 years, 105 (61%) were female, and 128 (74%) had risk factors for thrombotic disease. DVT was iliofemoral in 150 (87%) patients, and catheter-based treatment was given within 7 days of diagnosis in 92 (53%) patients. After venous stenting, 109 (63%) patients received anticoagulant-only therapy with a direct oral anticoagulant (29%), warfarin (22%), or low-molecular-weight heparin (10%), and 59 (34%) received anticoagulantantiplatelet therapy. In patients taking anticoagulant-only therapy, 29% received indefinite treatment; in patients on anticoagulant-antiplatelet therapy, 19% received indefinite treatment. Factors associated with combined anticoagulant-antiplatelet therapy vs anticoagulant-only therapy were use of thrombolytic, thrombectomy, and aspiration interventions (odds ratio [OR], 5.11; 95% CI, 1.45-18.05); use of balloon angioplasty (OR, 2.62; 95% CI, 1.20-5.76); and immediate stent restenosis (OR, 7.2; 95% CI, 1.45-5.89).Conclusion: Anticoagulant therapy without concomitant antiplatelet therapy appears to be the most common antithrombotic strategy in patients with DVT and venous

Automated summary

This study aimed to determine the type and duration of antithrombotic therapy used in patients with acute lower extremity DVT who received venous stents. The results showed that anticoagulant therapy without concomitant antiplatelet therapy is the most common antithrombotic strategy in these patients, with approximately 29% receiving indefinite treatment.