Does Catheter-Directed Thrombolysis Prevent Postthrombotic Syndrome?

Purpose: The aim of this study is to identify risk factors of postthrombotic syndrome (PTS) and evaluate the efficacy of catheter-directed thrombolysis (CDT) for preventing the development of PTS in patients with lower extremity deep vein thrombosis (DVT).

Materials and Methods: From 2005 January to 2013 December, 139 limbs of 126 patients were included in this study who had the first episode of proximal DVT at the affected limb and who had visited our out-patient clinic. CDT was performed on 55 limbs (39.6%). We achieved complete recanalization in 39 limbs (70.9%) and partial recanalization (residual thrombus <50.0%) in 16 limbs (29.1%). We retrospectively reviewed medical records for possible predictors of PTS.

Results: Median follow-up duration was 83 months (range, 30-136 months). No differences were found between the CDT and non-CDT group in age, gender, duration of symptom, use of anticoagulation and recurrence of DVT. A significantly higher thrombotic burden was observed in the CDT group (P=0.009). In a binary logistic regression model, patients with PTS had significantly higher body mass index (BMI) (odds ratio [OR], 1.303; 95% confidence interval [CI], 1.079-1.574; P=0.006) and longer thrombotic burden involved in ilio-femoro-popliteal DVT (OR, 3.666; 95% CI, 1.093-12.296; P=0.035). CDT did not influence the risk of PTS (P>0.05).

Conclusion: We suggest that CDT is not effective in preventing PTS, while higher BMI and longer thrombotic burden are associated with the development of PTS in patients with DVT.