Hospital da Luz Vila Real (HLVR) carried out an endovascular treatment of post-deep vein thrombosis syndrome using an innovative technique: for the first time at HLVR, a venous stent implant was placed by percutaneous endovascular technique. The procedure was carried out on July 24, having been performed by a team led by vascular surgeon Mário Marques Vieira, in which specialist João Rocha Neves also participated. The team proceeded to revascularization of an extensive obstruction of the deep venous system, of the abdominal and inguinal region, using a minimally invasive percutaneous technique, without incisions or scars, with an innovative stent implant dedicated to deep obstructive venous disease. It is an innovative treatment that allows treating patients with a history of abdominal and pelvic deep vein thrombosis, with severe sequelae, called post-thrombotic syndrome, which causes pain when walking or lameness, edema or chronic swelling, pigmentation and skin atrophy, appearance of extensive and atypical varicose veins, and skin ulceration in the most advanced and prolonged cases. Post-thrombotic syndrome develops after an event of deep venous thrombosis, starting approximately five years after that event, affecting more than 50% of patients at 10 years after thrombosis. The type, degree and severity of symptoms are all the more extensive the higher or closer the thrombosis is, especially the vena cava or iliac veins, and in the occurrence of sequelae obstruction of the deep system. The diagnosis is made through a previous clinical history and signs and symptoms of deep venous hypertension (edema, pigmentation, cutaneous atrophy, varicose veins and cutaneous ulceration), subsequently using venous echo-Doppler of the lower limbs and abdominal for imaging confirmation and hemodynamic study. Once the suspicion of deep venous obstruction by thrombosis and adjacent mechanisms is confirmed, often with concomitant compressive obstructive disease such as May-Thurner disease, an abdominal imaging method is performed, usually an Angio-CAT scan or Angio-MRI that confirms the venous obstruction, the existence of venous collateralization (pelvic, inguinal and / or abdominal varicose veins), being the essential exam for the treatment schedule. After revascularization and dedicated venous stent implantation, with results that are often immediate in relieving symptoms, the patient needs regular follow-up in the first year after treatment, using elastic stockings and pharmacological hypocoagulation treatment. After 12 months, treatment is usually suspended, extending surveillance to 6 or 12 months, depending on the case.
