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Venous mechanical thrombectomy for deep vein thrombosis in patients with cancer: a single-center prospective study

Year: 2026

Type: article

Abstract: To evaluate safety, efficacy, and clinical outcomes following venous mechanical thrombectomy (MT) for deep venous thrombosis (DVT) in cancer patients.This single-arm, single-center prospective study evaluated cancer patients with symptomatic lower extremity or caval DVT treated with venous mechanical thrombectomy. Patients were recruited between June 2023 and October 2024. The primary outcome was clinical success, which was defined as a reduction in Villalta score by ≥2 points at 6 months. Secondary outcomes included repeat intervention rates and overall survival (OS). Technical success was defined as restoring venous flow with mild (< 10%) or no residual filling defect. 25 patients (median age: 63 [IQR: 58–71]; 52% male) were included. All patients received anticoagulation prior to intervention. Contraindications to thrombolytics were present in 64% (16/25), and 15/25 had indwelling venous devices. Most patients had proximal clot burden, with IVC and iliac thrombus in 56% and 84%, respectively. Median Villalta scores improved significantly from 10.5 (IQR: 8–14) at baseline to 4 (IQR: 3–6.3) post-procedure (Wilcoxon, p< 0.001) and remained improved at 1- and 6-month follow-ups (p< 0.001). Technical success was 100%, and clinical success was 96% (24/25), with no repeat interventions. The 30-day and 6-month OS rates were 96% and 74%, respectively. One grade 3 CTCAE complication (access site hematoma) occurred. Pathologic analysis revealed tumor thrombus in 32% (7/22) of evaluable patients.MT provides rapid and durable relief from VTE-related symptoms, improving the quality of life in cancer patients with DVT. The high prevalence of tumor thrombus underscores thrombectomy’s versatility across thrombus types as well as the possible underdiagnosis of tumor thrombus in cancer patients.

Source: Blood Vessels Thrombosis & Hemostasis

DOI: 10.1016/j.bvth.2026.100172