No Difference in Patency Rates Between Postprocedural Anticoagulant and Antiplatelet Regimens following Recanalization of Thoracic Central Venous Occlusions.

Sunday, March 30, 2025

3:45 PM – 3:54 PM CT

Location: Music City Center, 202 BC

Presenting Author(s)

Hayden Lawrence Hofmann

Medical student
Keck School of Medicine of University of Southern California, United States

Author/Co-author(s)

RS

Russel Salamo, MD

Resident Physician
Keck School of Medicine of USC, United States
Jonathan Renslo, MS

Medical Student
USC, United States
XL

Xiaomeng Lei, MPH

Statistician
Keck School of Medicine, University of Southern California, United States
SC

Steven Cen, PhD

Professor of Research
Keck School of Medicine of University of Southern California, United States
RT

Ramon Ter-Oganesyan, MD

Interventional Radiologist
University of Southern California, United States
SS

Stuart Schroff, MD

Assistant Professor of Radiology
Keck School of Medicine of USC, United States
JV

Jenanan Vairavamurthy, MD

Assistant Professor of Radiology
Mount Sinai, United States
TC

Trevor Carle, MD

Assistant Professor of Radiology
Keck School of Medicine of USC, United States

Purpose:

The study explores the effect of postprocedural anticoagulant and antiplatelet

regimens, recanalization technique, and type of stent on primary patency rates for patients undergoing thoracic central venous recanalization.

Materials and Methods: A retrospective review of TCVO (thoracic central venous occlusion) recanalization procedures between 2009 and 2023 at a private tertiary-care hospital and a public safety-net hospital was performed. Clinical success, primary patency, primary assisted patency, secondary patency along with stent characteristics and postprocedural anticoagulation/antiplatelet regimens were collected. Analysis of variance was performed to compare treatment groups with Dunnet’s test as a post-hoc analysis.

Results: Of the 76 procedures, 59 were dialysis patients. Recanalization success was 78.9% (60/76), with the vast majority through blunt techniques. Primary patency of successful cases at 6 months was 45% (27/60, median primary patency 5 months, IQR 5.625 months). Discharge anticoagulation/antiplatelet, stent characteristics, and the technical placement of the stent showed no difference in total patency outcomes; Table 1.

Conclusion:

There was no difference in follow up patency rates between postprocedural anti-thrombotic and anticoagulation regimens at 6 months. Recommendations may be closely tailored to additional patient comorbidities in the absence of clear data supporting an optimal regimen. More research is required to fully evaluate the optimal postprocedural antithrombotic and anticoagulant pharmacotherapy following central venous recanalization.