• Caroline Menez, Mathieu Rodiere, Julien Ghelfi, Christophe Seinturier, Thomas Martinelli, Bernard Imbert, Romain Perolat, Pierre Bouzat, Sophie Blaise, Patrick Carpentier, Gilles Pernod, and Frédéric Thony.
• Department of Vascular Medicine, Grenoble Alpes University Hospital, Hôpital Albert Michallon, CS 10217, 38043, Grenoble, France.
• Cardiovasc Intervent Radiol. 2019 Aug 1; 42 (8): 1117-1127.

ObjectivesTo propose a scale of severity for post-thrombotic venous lesions (PTVLs) after ilio-femoral deep venous thrombosis and to compare the grade with the results of endovascular treatment of ilio-femoral PTVLs.MethodsIn this retrospective monocentric observational study, we included 95 patients treated for ilio-femoral PTVLs. We proposed a four-grade scale evaluating the severity of PTVLS caudal to the common femoral vein based on CT phlebography and per-operative phlebography. For most patients, venous patency was assessed with color duplex ultrasonography and the clinical efficacy of the intervention using the Villalta and CIVIQ scores.ResultsRecanalization was successful in 100% of patients with a morbidity rate of 4%. After a mean follow-up of 21 months, the overall primary patency was 75%, the assisted primary patency 82%, and the secondary patency 93%. Secondary patency was 100% for grade 0-1, 90% for grade 2, and 63% for grade 3 (p < 0.002). There was no correlation between the extension of stenting caudally of the common femoral vein and venous patency. The mean improvements in the Villalta and CIVIQ-20 scores were, respectively, 4.6 (p < 0.0001) and 18 (p < 0.0001); scores were not correlated with the grade of PTVLs in the thigh.ConclusionVenous patency after endovascular treatment of ilio-femoral PTVLs was strongly linked to the severity of PTVLs caudal to the common femoral vein but not to the extent of stenting.

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