Abstract No. 62 Analysis of Pediatric Venous Thromboembolism Interventions

The aim of this study was to analyze indications, patient characteristics, and outcomes associated with thrombectomy and/or thrombolysis of VTE. Pediatric patients diagnosed with and treated for VTE at a tertiary academic children's medical center between 2008 and 2023 were identified via electronic medical records. Study data, including baseline and demographic characteristics, prior therapy, additional therapies, and interventions were extracted from the patients' charts. Clinical outcomes, safety metrics, subsequent imaging, and clinical follow up were also obtained. Analysis was completed to compare patient outcomes following different treatment modalities. 32 pediatric patients were diagnosed with VTE during the study period. 18 patients underwent thrombolysis, 14 patients underwent mechanical thrombectomy, and 10 patients had an IVC filter placed. VTE cases often occurred with additional co-morbidities including May-Thurner syndrome (n=8), sickle cell disease (n=2), SVC syndrome (n=2), and hemoglobin S deficiency (n=2). Every pediatric patient diagnosed with VTE had at least one clotting risk factor as previously noted and/or obesity, pre-diabetes, or extended hospitalization requiring long periods of immobility. The most common anticoagulation utilized in this cohort following VTE diagnosis was Lovenox with 13 of 14 (93%) patients with 1 of 14 (7%) patients receiving rivaroxaban. Mechanical thrombectomy procedures had the greatest technical success, with no procedures being aborted. Patients who underwent thrombolysis and thrombectomy required reintervention 58% and 47% of the time, respectively. Pediatric patients that underwent pharmacological thrombolysis had a higher rate of subsequent VTE intervention compared to patients undergoing mechanical thrombectomy.