Symptomatic Iliofemoral and Iliocaval Venous Thrombosis in Patients With Cancer: Endovascular Treatment

Introduction: Proximal (iliocaval and iliofemoral) deep vein thrombosis (DVT) and pulmonary thromboembolism are the second cause of death in patients with cancer. Material and Methods: A retrospective analysis was performed in 35 patients with cancer treated with endovascular therapy for proximal DVT. The primary objective was to evaluate the technical success of the procedure and the 30-day and long-term symptom improvement. Results: Thirty-five patients with a mean age of 57.7 years were treated. In 27 patients, DVT was due to tumor compression and/or invasion of the iliocaval venous axis, and in the remaining 8, it was secondary to their hypercoagulability state. The revascularization techniques used were manual catheter-directed aspiration of the thrombus plus angioplasty and stenting. Technical success was achieved in 33 patients. No complications occurred. Twenty-seven patients were followed up at 30 days posttreatment: 21 were free of postthrombotic syndrome, 4 (14.8%) had mild symptoms, and 2 (7.4%) had moderate symptoms. The mean long-term follow-up was 27.3 months, with a primary patency of 68.8% and assisted and secondary patency rates of 100%. Conclusion: Endovascular revascularization in patients with cancer with extensive and symptomatic proximal DVT is safe and efficient, with a low rate of complications. We consider that this therapy should be offered to patients with cancer with an average or long life expectancy.