May-Thurner Syndrome (MTS) with acute iliofemoral deep vein thrombosis (IFDVT) carries high risks of limb ischemia and post-thrombotic syndrome (PTS). Traditional treatments like catheter-directed thrombolysis have limitations, including high major bleeding risk and prolonged hospital stays. A retrospective cohort study included 52 patients with MTS-related acute IFDVT (one-stop group: 27, Angiojet mechanical thrombectomy + simultaneous iliac vein stenting; traditional group: 25, catheter-directed thrombolysis alone or with delayed stenting). Main outcomes were 24-hour limb circumference edema reduction rate, 6-month iliac vein patency (stenosis .05). The one-stop group had better 24-hour limb circumference edema reduction rate (15 cm above knee: 82.2 ± 4.9% vs 73.6 ± 2.4%; 15 cm below knee: 70.0 ± 8.2% vs 58.5 ± 7.4% in the traditional group, both P < .01), higher 6-month patency (81.48% vs 32.00%, P < .001), lower PTS incidence (11.11% vs 76.00%, P < .001), and less severe bleeding (3.70% vs 24.00%, P < .05). The one-stop strategy offers superior early swelling relief, significantly higher 6-month iliac vein patency (81.48% vs 32.00%, P < .001), lower PTS risk, and better safety for MTS-related IFDVT, supporting it as a preferred clinical option.
Shao et al. (Fri,) studied this question.