Endovascular Therapy for Patients with Post-Thrombotic Syndrome and Iliac Vein Obstruction: Primary Results from the NIH-Sponsored C-TRACT Randomized Trial

Monday, April 13, 2026

10:39 AM - 10:48 AM ET

Location: Exhibit Hall F

Presenting Author(s)

SV

Suresh Vedantham, MD (he/him/his)

Professor and Assistant Dean
Mallinckrodt Institute of Radiology, United States

Author/Co-author(s)

SK

Susan Kahn, MD, MSc

Professor of Medicine
McGill University, United States
WM

William Marston, MD

Professor
University of North Carolina, United States
Ido Weinberg, MD

Associate Professor of Medicine
Massachusetts General Hospital / Harvard Medical School, United States
Akhilesh Sista, MD

Professor
Weill Cornell Medicine, United States
EM

Elizabeth Magnuson, PhD

Professor
Mid America Heart Institute, United States
DC

David Cohen, MD, MS

Director of Clinical and Outcomes Research
Cardiovascular Research Foundation, United States
Suman Wasan, Clinical Professor Medicine

Vascular Medicine Specialists
UNC Rex Health, United States
MR

Mahmood K. Razavi, MD, FSIR

Interventional Radiologist
Vascular and Interventional Specialists of Orange County, Inc, United States
SG

Samuel Goldhaber, MD

Professor
Harvard Medical School, United States
KS

Kristen Sanfilippo, MD

Associate Professor, Hematology Division
Washington University School of Medicine, United States
AC

Anthony Comerota, MD

Medical Director Emeritus
Inova Heart and Vascular Institute Fairfax, United States
BW

Borong Wang, MS

Statistician
McMaster University, Canada
YW

Yang Wang, MS

Statistician
McMaster University, Canada
SP

Sameer Parpia, PhD

Associate Professor
McMaster University, Canada

Purpose:

To evaluate the ability of endovascular therapy (EVT) to reduce the severity of post-thrombotic syndrome (PTS) in patients with chronic iliac vein obstruction via the Chronic Venous Thrombosis: Relief with Adjunctive Catheter-Directed Therapy (C-TRACT) Trial.

Materials and Methods:

225 patients with moderate or severe PTS and documented iliac vein obstruction (occlusion or > 50% stenosis) were randomized 1:1 to receive EVT (iliac vein stent placement and augmented anti-thrombotic therapy for 6 months) plus standard PTS care versus standard PTS care alone in 29 clinical centers. Randomization was stratified by the presence/absence of an open venous ulcer, the status of the common femoral vein (CFV) on ultrasound (fully compressible without internal webbing, or not), and clinical center. Patients in both treatment groups were followed for 24 months. The primary outcome was the severity of PTS at 6 months, adjusted for baseline, graded by a clinician assessor who was blinded to treatment group, using the validated Venous Clinical Severity Scale (VCSS). Additional outcomes assessed at 6 months included venous disease-specific (VEINES-QOL questionnaire) and overall (SF-36 health survey) quality of life, Villalta PTS severity, calf volume, the presence of an open venous ulcer, recurrent venous thromboembolism, major bleeding, death, and peri-procedure complications.

Results: At the time of abstract submission, patient follow-up and outcome assessment through 6 months post-randomization were complete, with database lock expected to occur before 2025 end. Based on the last data safety monitoring board open report when 222 patients had been randomized, the study population had a median age of 55 years; 47% were female; 67% were White; 24% were Black; 12% were of Hispanic ethnicity; 15% had a venous ulcer; 46% had a normal CFV; and the median baseline Villalta score was 15. The treatments delivered (anti-thrombotic drugs, compression therapy, venoactive drugs, EVT) and primary and secondary outcomes observed through 6 months follow-up will be reported for both treatment groups.

Conclusion:

This presentation will report on the primary and secondary outcomes through 6 months from the C-TRACT randomized trial that assessed the effect of EVT upon PTS severity.