The Reading Room Podcast: IR Study Shows Benefits of Endovascular Therapy for Reducing Severity of Post-Thrombotic Syndrome

Can the endovascular therapy combination of iliac vein stent placement and augmented anti-thrombotic therapy have an impact for patients with post-thrombotic syndrome (PTS) and chronic iliac vein obstruction?

In a randomized multicenter study sponsored by the National Institutes of Health (NIH), researchers compared the aforementioned endovascular therapy combination with standard PTS care versus standard PTS care alone in 225 patients (median age of 55) with moderate or severe PTS. All patients in the cohort for the Chronic Venous Thrombosis: Relief with Adjunctive Catheter-Directed Therapy (C-TRACT) trial had occlusion or > 50 percent stenosis in the iliac vein, according to the study.¹

The study findings, recently presented at the Society for Interventional Radiology (SIR) 2026 Annual Scientific Meeting, revealed a 53 percent reduction in the number of patients with severe PTS after six months of endovascular therapy (93 percent at baseline vs. 40 percent at six months).¹

In a new Diagnostic Imaging podcast, Suresh Vedantham, MD, FSIR, an interventional radiologist and primary investigator on the study, discussed the impact of the minimally invasive stent therapy.

“We found that patients who had been stented had significantly reduced severity of their post-thrombotic syndrome. They also had significantly improved health-related quality of life, and that's both on a scale that measured mostly venous symptoms, and then also a scale that really was focused on overall quality of life,” noted Dr. Vedantham, a professor of radiology with the Mallinckrodt Institute of Radiology at the Washington University School of Medicine in St. Louis.

The study findings were achieved in a diverse cohort (with women, Black patients and Hispanic patients comprising 47 percent, 24 percent and 12 percent of the cohort respectively) drawn from a variety of academic and community health-care facilities.

“ … We do feel that overall, (the) C-TRACT (results) add to the data that was there, but in itself, I think it supports generalization and applicability of the findings to clinical practice better than other studies,” added Dr. Vedantham, who has performed the iliac vein stenting procedure for 27 years.

For more insights from Dr. Vedantham, listen below or subscribe on your favorite podcast platform.

(Editor’s note: For related content, see “Can Photon-Counting CT Improve Differentiation of Portal Vein Thrombosis?,” “DVTs and PEs: Imaging’s Role in Managing Blood Clot Dangers in COVID-19” and “Key Takeaways from Multidisciplinary Roundtable on Intravascular Ultrasound Use for Peripheral Vascular Interventions.”)

Reference

1. Vedantham S, Kahn S, Maraton W, et al. Endovascular therapy for patients with post-thrombotic syndrome and iliac vein obstruction: primary results from the NIH-sponsored C-TRACT randomized trial. Presented at the Society for Interventional Radiology (SIR) 2026 Annual Scientific Meeting, April 11-15, Toronto, Canada.