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Study Shows Stents Are Superior to Balloons Alone for Patients With Deep Venous Thrombosis

Saturday, May 7, 2011 Research News
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EVISTA-DVT Trial Shows High-Grade Stenosis in Veins Treated With Stents After Thrombolysis More Than Twice as Likely to Stay Open

BALTIMORE, May 6, 2011 /PRNewswire/ -- Stenting is safe and effective and superior to balloon angioplasty for treatment of venous stenosis in patients with deep vein thrombosis (DVT), according to results from EVISTA-DVT, presented today as a Late-Breaking Clinical Trial at the Society for Cardiovascular Angiography and Interventions (SCAI) 2011 Scientific Sessions in Baltimore.
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EVISTA-DVT focused on patients with blocked veins who had received clot-buster drug therapy (thrombolysis). Researchers found stenting was more effective than balloons alone at restoring and maintaining blood flow through the thigh veins.
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"We are encouraged by these study results," said Mohsen Sharifi, MD, FSCAI, director of Arizona Cardiovascular Consultants and adjunct professor at A.T. Still University in Mesa, Ariz. "For patients with DVT, stenting is a viable option, as demonstrated by the success rates for patients studied in this trial."

DVT affects approximately 350,000 to 600,000 Americans each year. Blood clots form in a vein in the lower leg and thigh. If left untreated, the clot can block blood flow through the vein. If the clot moves through the bloodstream, it can get stuck in the lungs leading to pulmonary embolism and possibly death. It is estimated at least 100,000 deaths may be directly or indirectly related to DVT and blood clots that travel to the lungs. Inserting a stent – a tiny mesh tube – opens up the blockage that may cause future clot formation.

The trial included 141 patients who had initial clot-dissolving drug therapy, but continued to have blockage of their vein. Patients were randomly assigned to further treatment with stenting (71 patients) or balloon venoplasty alone (70 patients) to open up the blocked vein. Every six months researchers checked blood flow through the leg veins using ultrasound.

During a follow-up that averaged 35 months, three patients (4%) in the stent group and seven patients (10%) in the balloon venoplasty group redeveloped DVT. The patency – or openness – of the treated vein was higher in the stent group versus the control group.

"Although stenting is common in the coronary and peripheral arteries, it is still relatively uncommon – and its outcome fundamentally different – in the venous segments below the groin, such as those found in the thigh veins," said Dr. Sharifi. "Over the last decade, we have seen improved patient outcomes with percutaneous endovenous intervention( PEVI) for the treatment of DVT."

Dr. Sharifi reports no conflicts of interest.

Dr. Sharifi will present "Endovenous Infra-Inguinal Stenting and Angioplasty in Deep Vein Thrombosis Trial – EVISTA-DVT Trial" in the General Session on Friday, May 6, 2011, 9:30 a.m. to 9:45 a.m.

About SCAI

Headquartered in Washington, D.C., the Society for Cardiovascular Angiography and Interventions is a 4,000-member professional organization representing invasive and interventional cardiologists in approximately 70 nations. SCAI's mission is to promote excellence in invasive and interventional cardiovascular medicine through physician education and representation, and advancement of quality standards to enhance patient care. SCAI's annual meeting has become the leading venue for education, discussion, and debate about the latest developments in this dynamic medical specialty. SCAI's patient and physician education program, Seconds Count, offers comprehensive information about cardiovascular disease. For more information about SCAI and Seconds Count, visit www.scai.org or www.SecondsCount.org.

SOURCE Society for Cardiovascular Angiography and Interventions (SCAI)

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