Early and long-term outcomes for postpartum deep vein thrombosis: the role of endovascular treatment

Objective To investigate the effect of endovascular treatment to initial and long-term outcomes of postpartum deep venous thrombosis (DVT) . Methods The clinical data, venography and 3-yaer follow up data of 30 female patients with acute or subacute deep vein thrombosis in the postpartum period who received endovascular therapy consisting of catheter-directed thrombolysis with angioplasty(stenting for some patients with iliac vein compression syndrome (IVCS)) were retrospectively evaluated. Clot removal was graded as grade Ⅲ(>95%), grade Ⅱ(50% to 95%), and grade Ⅰ(<50%). Grade Ⅱ, Ⅲ considered effective. Data from onset time, vaginal delivery or by elective, patients ages, IVCS or not and stenting or not were included in this analysis. And the χ2 test and survival analysis was used for statistical analysis of initial and long-term patency respectively. Results In 30 cases, the initial result included 14 cases(46.7%) of grade Ⅲ, 12 cases(40.0%) of grade Ⅱ and 4 cases(13.3%) of grade Ⅰ. Patients' onset time, vaginal delivery or by elective, patients ages and IVCS or not have no significant statistical difference to initial patency (χ2=0.88, 1.28, 1.15, 3.08, P>0.05) .For 18 patients with IVCS, there was significant statistical difference between patients implanting stents(initial patency was 100.0% (7/7) and whom not implanting stents(initial patency was 63.6% ,7/11) (χ2=5.14, P 0.05). Conclusions Endovascular therapy consisting of catheter-directed thrombolysis with angioplasty could be considered as a primary therapeutic procedure in patients with acute or subacute postpartum DVT. Stenting for treatment of iliac compression which contributed to postpartum DVT is very valuable to ensuring higher long-term patency rate. Key words: Venous thrombosis; Postpartum period; Radiology, interventional