Antiplatelet Therapy is Associated with Stent Patency After Iliocaval Venous Stenting

Autor: Kenneth J. Kolbeck, Keng Wei Liang, Yasufumi Ohuchi, Robert E. Barton, Masahiro Horikawa, Masayuki Endo, John A. Kaufman, Younes Jahangiri, Khashayar Farsad, Ryan C. Schenning
Rok vydání: 2018
Předmět:
Adult
Diagnostic Imaging
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Vena Cava
Inferior
Iliac Vein
030204 cardiovascular system & hematology
030218 nuclear medicine & medical imaging
Young Adult
03 medical and health sciences
0302 clinical medicine
Risk Factors
Occlusion
Antithrombotic
medicine
Humans
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
Vascular Patency
Aged
Proportional Hazards Models
Retrospective Studies
Venous Thrombosis
Aspirin
business.industry
Warfarin
Anticoagulants
Stent
Middle Aged
equipment and supplies
medicine.disease
Clopidogrel
Thrombosis
Surgery
Stenosis
surgical procedures
operative
Drug Therapy
Combination
Equipment Failure
Female
Stents
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
medicine.drug
Zdroj: CardioVascular and Interventional Radiology. 41:1691-1698
ISSN: 1432-086X
0174-1551
DOI: 10.1007/s00270-018-2062-5
Popis: To examine the effectiveness of antithrombotic medications to prevent venous stent malfunction for iliocaval occlusive disease. A retrospective analysis was performed on 62 patients who underwent technically successful endovascular iliocaval stent placement between May 2008 and April 2017. Clinical records were reviewed for demographic information, procedure details, post-stenting antithrombotic prophylaxis and stent patency on follow-up. Stent malfunction was defined as > 50% stenosis or occlusion at follow-up. Risk factors for stent malfunction were assessed with univariable and multiple Cox proportional hazard models. The median follow-up period was 11.6 months (range 0.1–76.4). Overall primary and secondary cumulative patency rates at 12 months were 70.0% and 92.4%, respectively. After stent placement, 97% of patients received anticoagulation with warfarin, enoxaparin or a factor Xa inhibitor. In addition, 61% received antiplatelet prophylaxis with aspirin, clopidogrel or a combination. In multiple Cox regression analysis, post-stenting antiplatelet use remained significantly associated with primary stent patency (HR = 0.28, P = 0.022). After iliocaval venous stenting, stent patency was best predicted by concomitant antiplatelet and anticoagulation therapy rather than anticoagulation alone. This novel finding warrants further research underlying mechanisms leading to venous stent thrombosis, and has implications for optimal medical management after venous stenting.
Databáze: OpenAIRE
Externí odkaz: