TY - JOUR
T1 - Mechanical Venous Thrombectomy for Deep Venous Thrombosis in Cancer Patients
T2 - A Single-Center Retrospective Study
AU - Patel, Riya M.
AU - Pal, Koustav
AU - Ahmed, Syed Hadi
AU - Kuban, Joshua D.
AU - Patel, Milan
AU - Shah, Ketan
AU - Habibollahi, Peiman
AU - Metwalli, Zeyad
AU - Gurusamy, Varshana
AU - Gupta, Sanjay
AU - Rojas-Hernandez, Cristhiam M.
AU - Afshar-Kharghan, Vahid
AU - Kroll, Michael H.
AU - Sheth, Rahul A.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - Purpose: Venous thromboembolism (VTE) is a major contributor to the mortality of cancer patients. Mechanical thrombectomy (MT) is an endovascular technique that physically removes a thrombus without thrombolytics. The purpose of this study was to evaluate safety, efficacy, and clinical outcomes following MT for lower extremity DVT in cancer patients. Methods: This single-center, retrospective study evaluated outcomes following MT of lower extremity DVT in cancer patients from November 2019 to May 2023. The primary outcome measure was clinical success, defined as a decrease in Villalta score by at least 2 points following the intervention. Secondary outcomes included repeat intervention-free survival and overall survival. Technical success was defined as restoring venous flow with mild (< 10%) or no residual filling defect. Results: In total, 90 patients and 113 procedures were included. Technical and clinical success was achieved in 81% and 87% of procedures performed. Repeat intervention-free survival at 1 month, 3 months, and 6 months post-procedure was 92%, 82%, and 77%, respectively. The complication rate was 2.7%. Pathologic analysis of the extracted thrombus revealed tumor thrombus in 18.4% (18/98) samples. Overall survival for the study cohort was 87% at 1 month, 74% at 3 months, and 62% at 6 months. Patients who were found to have tumor thrombi were noted to have a decreased overall survival compared to patients with non-tumor thrombi (P = 0.012). Conclusion: MT is safe and efficacious in reducing cancer patients’ VTE-related symptoms. The high rate of tumor thrombus in thrombectomy specimens suggests this phenomenon is more common than suspected. Graphical Abstract: (Figure presented.)
AB - Purpose: Venous thromboembolism (VTE) is a major contributor to the mortality of cancer patients. Mechanical thrombectomy (MT) is an endovascular technique that physically removes a thrombus without thrombolytics. The purpose of this study was to evaluate safety, efficacy, and clinical outcomes following MT for lower extremity DVT in cancer patients. Methods: This single-center, retrospective study evaluated outcomes following MT of lower extremity DVT in cancer patients from November 2019 to May 2023. The primary outcome measure was clinical success, defined as a decrease in Villalta score by at least 2 points following the intervention. Secondary outcomes included repeat intervention-free survival and overall survival. Technical success was defined as restoring venous flow with mild (< 10%) or no residual filling defect. Results: In total, 90 patients and 113 procedures were included. Technical and clinical success was achieved in 81% and 87% of procedures performed. Repeat intervention-free survival at 1 month, 3 months, and 6 months post-procedure was 92%, 82%, and 77%, respectively. The complication rate was 2.7%. Pathologic analysis of the extracted thrombus revealed tumor thrombus in 18.4% (18/98) samples. Overall survival for the study cohort was 87% at 1 month, 74% at 3 months, and 62% at 6 months. Patients who were found to have tumor thrombi were noted to have a decreased overall survival compared to patients with non-tumor thrombi (P = 0.012). Conclusion: MT is safe and efficacious in reducing cancer patients’ VTE-related symptoms. The high rate of tumor thrombus in thrombectomy specimens suggests this phenomenon is more common than suspected. Graphical Abstract: (Figure presented.)
KW - Cancer
KW - Endovascular
KW - Mechanical thrombectomy
KW - Venous thromboembolism
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U2 - 10.1007/s00270-024-03691-3
DO - 10.1007/s00270-024-03691-3
M3 - Article
C2 - 38548981
AN - SCOPUS:85189135593
SN - 0174-1551
JO - Cardiovascular and Interventional Radiology
JF - Cardiovascular and Interventional Radiology
ER -