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. 2025 Nov;13(6):102287.
doi: 10.1016/j.jvsv.2025.102287. Epub 2025 Jul 11.

Predictive factors for complete recovery of post-thrombotic syndrome 6 months after venous recanalization

Lina Khider  1 , Costantino Del Giudice  2 , Nicolas Gendron  3 , Chloé Gobert  4 , Benjamin Planquette  5 , Marc Al Ahmar  6 , Guillaume Goudot  7 , Emmanuel Messas  7 , Marc Sapoval  6 , Tristan Mirault  7
Affiliations

Predictive factors for complete recovery of post-thrombotic syndrome 6 months after venous recanalization

Lina Khider et al. J Vasc Surg Venous Lymphat Disord. 2025 Nov.

Abstract

Objective: Endovascular recanalization is considered for severely symptomatic patients with post-thrombotic syndrome (PTS) to alleviate symptoms. However, data on complete recovery and its predictors remain limited. This study aimed to assess persistent PTS 6 months after venous recanalization and identify predictive factors.

Design: Single-center retrospective outcome-oriented cohort study.

Methods: We reviewed electronic medical records of patients referred for endovascular venous recanalization between January 1, 2015, and September 30, 2019. Inclusion criteria were PTS defined by a Villalta score of ≥5 or a leg ulcer ≥6 months after a deep vein thrombosis episode. Complete PTS recovery was defined as a Villalta score of <5.

Results: Sixty-seven patients (median age, 40 years; interquartile range, 32-51 years; 78% women; 18% obese) were included. The initial Villalta score was 10 (interquartile range, 7-14). At 6 months, primary and secondary patency rates were 75% and 81%, respectively. Complete recovery was observed in 67% of patients. Multivariate analysis identified the initial Villalta score (odds ratio, 1.36; 95% confidence interval, 1.12-1.65; P = .002) and femoral vein obstruction (odds ratio, 3.79; 95% confidence interval, 1.06-13.61; P = .041) as predictors of persistent PTS, whereas long-term anticoagulation was not significant.

Conclusions: Endovascular recanalization achieved PTS resolution in two-thirds of patients at 6 months, particularly in those with a low initial Villalta score and no femoral vein obstruction. A risk score incorporating these factors may aid clinicians in patient counseling regarding the expected benefits of the procedure.

Keywords: Chronic venous thrombotic obstruction; Deep venous thrombosis; Post-thrombotic syndrome; Prediction; Stenting.

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Conflict of interest statement

Disclosures L.K., N.G., and T.M. acknowledge the following without any relation with the current manuscript. L.K. reports receiving honoraria from Bristol-Myers Squibb, Viatris, and Pfizer SAS and receiving nonfinancial support from Bristol-Myers Squibb, Viatris, Pfizer SAS, Leo Pharma, and Sanofi. N.G. discloses consulting fees or travel awards by Bayer, Bristol-Myers Squibb/Pfizer, and LEO-Pharma. T.M. reports receiving honoraria from Bayer Healthcare SAS and Incyte Biosciences France and receiving nonfinancial support from Abbott France, Alexion Pharma France, Amgen SAS, Bayer Healthcare SAS, Boehringer Ingelheim France, Bristol-Myers Squibb, ICOMED, Incyte Biosciences France, MSD France, and Pfizer SAS.

Figures

Fig 1
Fig 1
Flow chart. PTS, post-thrombotic syndrome.
Fig 2
Fig 2
Sankey diagram of post-thrombotic syndrome (PTS) severity change during follow-up after endovascular procedures.
See this image and copyright information in PMC

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