Primary patency after iliofemoral venous stenting was similarly high with dual-pathway antithrombotic therapy (anticoagulation plus antiplatelet therapy) and anticoagulation alone, though an exploratory analysis suggested a possible association between AC+APT and improved patency in patients with post-thrombotic syndrome.
Overall primary stent patency was high regardless of antithrombotic regimen during a median follow-up of 24 months.
Dual-pathway antithrombotic therapy (AC+APT) did not significantly differ from anticoagulation alone in primary patency in the overall cohort.
In the post-thrombotic syndrome subgroup, anticoagulation alone was associated with a higher risk of patency loss compared with dual-pathway antithrombotic therapy.
Cox regression was used to identify independent predictors of loss of primary patency after iliofemoral venous stenting.
The authors concluded that adequately powered randomized trials with longer follow-up are needed to confirm the possible association between AC+APT and improved patency in post-thrombotic syndrome patients.
This research suggests that after having a stent placed in the large veins of the pelvis and upper leg (iliofemoral veins), patients do well overall whether they take blood thinners alone or blood thinners combined with antiplatelet drugs (like aspirin or clopidogrel). In a study of 247 patients followed for about two years, over 91% of stents remained open and functioning, and there was no meaningful difference in stent patency between the two medication groups when looking at all patients together. However, the study found a potentially important exception: among patients who had post-thrombotic syndrome — a chronic condition caused by prior blood clots that damage vein valves and walls — those taking blood thinners alone were about three times more likely to lose stent patency compared to those on the combined regimen. This finding was described as exploratory, meaning it was not the main question the study was designed to answer and should be interpreted cautiously. This research matters because there is currently no established standard for what medications patients should take after venous stenting, and doctors vary in their approaches. While the overall results are reassuring that both strategies work well, the suggestion that post-thrombotic syndrome patients might particularly benefit from combined therapy warrants further investigation. The authors note that larger, randomized clinical trials with longer follow-up periods are needed to confirm this possible benefit and to fully evaluate the bleeding risks that come with using two types of blood-thinning medications together.
Chen C, Guo Z, Tang J, Wei Z, Liu G, Shi Z, et al.. (2026). Association of dual-pathway antithrombotic therapy with primary patency after iliofemoral venous stenting: a multicenter cohort study.. Research and practice in thrombosis and haemostasis. https://doi.org/10.1016/j.rpth.2026.106965