OBJECTIVE

To compare the results of conservative and endovascular treatment of deep vein thrombosis followed by acute severe venous insufficiency.

MATERIAL AND METHODS

Two statistically valid groups of patients with deep vein thrombosis and acute severe venous insufficiency were compared. Warfarin was administered in the first group, endovascular methods — in the second group (n=30). At the first step, we performed catheter-guided thrombolysis, then transcutaneous mechanical thrombectomy and venous stent deployment. Anticoagulation was achieved with Apixaban. Hemorrhagic complications were monitored during the treatment. One-year results were assessed considering lumen patency restoration and severity of venous congestion with Villalty score.

RESULTS

In the first group, each third patient had hemorrhagic complications that required cessation of anticoagulant therapy in 1.3% of patients. In the second group, hemorrhagic events occurred in 10% of patients and were managed by lowering Apixaban dosage. Complete restoration of lumen patency was detected in 23.3% in the first group and 93.3% in the second group. Partial restoration developed in 63.3% and 6.7%, occlusion in 13.3% and 0%, respectively. Only 23.3% of patients in the first group had no clinical evidence of venous congestion. Mild congestion was found in 20%, severe — in 56.7% of cases. In the second group, 6.7% of patients had minimal venous congestion.