Is Anticoagulation Alone Sufficient After Caval or Iliofemoral Venous Stenting for PTS?

Post-thrombotic syndrome (PTS), manifested by chronic pain, discoloration, and leg swelling, is a common occurrence for patients with proximal deep vein thrombosis and may impact quality of life. Endovascular recanalization of chronically occluded femoral or iliac veins or the inferior vena cava has been attempted to improve symptoms in PTS. However, the optimal antithrombotic regimen post-stenting remains unknown.

In an industry-funded, multicenter, randomized trial, the investigators assigned patients in a 1:1 ratio to low-dose aspirin plus rivaroxaban (20 mg once daily) or rivaroxaban monotherapy (NCT04128956). The trial was terminated prematurely owing to slow recruitment after enrollment of 169 patients. The incidence of the primary eff…