Res Pract Thromb Haemost. 2026 Sep 15;10(7):106965. doi: 10.1016/j.rpth.2026.106965. eCollection 2026 Oct.
ABSTRACT
BACKGROUND: The optimal antithrombotic strategy after iliofemoral venous stenting remains uncertain.
OBJECTIVES: This study aimed to evaluate the association of dual-pathway antithrombotic therapy with primary patency after iliofemoral venous stenting.
METHODS: This ambispective, multicenter observational study included consecutive patients who underwent successful iliofemoral venous stent implantation between 2019 and 2024. Patients were categorized according to their postoperative antithrombotic regimen into dual-pathway antithrombotic therapy (anticoagulation plus antiplatelet therapy [AC+APT]) and anticoagulation (AC) alone groups. The primary outcome was primary stent patency. Cox regression was used to identify independent predictors of loss of patency.
RESULTS: A total of 247 patients were included, with 145 receiving AC+APT and 102 receiving AC alone. During a median follow-up of 24 months (IQR, 15-38 months), the overall primary patency rate was 91.1%. Primary patency did not differ significantly between the AC+APT and AC groups in the overall cohort (log-rank P = 1.00). However, in the post-thrombotic syndrome subgroup, AC alone was associated with a higher risk of patency loss compared with AC+APT (hazard ratio, 3.31; 95% CI, 1.02-10.74; P = .047).
CONCLUSION: Primary patency after iliofemoral venous stenting was similarly high with dual-pathway antithrombotic therapy and AC alone. An exploratory analysis suggested a possible association between AC+APT and improved patency in patients with post-thrombotic syndrome. Adequately powered randomized trials with longer follow-up are needed to confirm this finding and assess long-term safety.
PMID:42892923 | PMC:PMC13675916 | DOI:10.1016/j.rpth.2026.106965