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NIH-Sponsored Trial Finds Stent Treatment Improves Outcomes for Post-Thrombotic Syndrome

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Stent Treatment Shows Promise for Severe Post-Thrombotic Syndrome in Landmark Trial

A major randomized clinical trial has found that adding stent placement to standard medical therapy leads to greater improvement in symptoms and quality of life for patients with moderate to severe post-thrombotic syndrome (PTS), a long-term complication of deep vein thrombosis. The results were presented at a medical conference and published in a leading journal.

Study Overview and Design

The Chronic Venous Thrombosis: Relief with Adjunctive Catheter-Directed Therapy (C-TRACT) trial was a randomized, multicenter study. It enrolled 225 patients with moderate to severe PTS across 29 institutions.

Patients were randomly assigned to one of two treatment groups:

  • Active Treatment Group: Received blood-thinning drugs (anticoagulation), compression therapy, and the placement of stents in blocked veins.
  • Control Group: Received blood-thinning drugs and compression therapy without stenting.

The trial received primary support from the U.S. National Institutes of Health (NIH) with additional support from the Society of Interventional Radiology (SIR) Foundation.

It was co-led by researchers at Washington University School of Medicine in St. Louis and McMaster University in Hamilton, Canada. The stent placement procedures were primarily performed by interventional radiologists.

Reported Results

The study's findings, presented at the Society of Interventional Radiology's 2026 Annual Scientific Meeting and published in the New England Journal of Medicine on April 13, 2026, indicated:

  • Patients in the stent treatment group showed greater improvement in PTS severity scores compared to patients in the control group.
  • This improvement correlated with better self-reported quality of life at the 6-month follow-up point.
  • At the beginning of the trial, 93% of all enrolled patients had PTS classified as "severe" according to the Venous Clinical Severity Score (VCSS).
  • At the 6-month assessment, 40% of the patients in the stent treatment group were classified as having severe disease.

Background on Post-Thrombotic Syndrome

Post-thrombotic syndrome is a potential long-term complication of deep vein thrombosis (DVT), which is a blood clot that forms in a deep vein, usually in the leg.

  • An estimated 600,000 Americans experience DVT each year.
  • Approximately 40% of individuals who have a DVT develop PTS.
  • PTS symptoms include chronic leg pain, swelling, a feeling of heaviness or fatigue, and, in severe cases, skin changes and venous ulcers.
  • The condition develops when a DVT damages valves in the veins, leading to blocked or backward blood flow (reflux).
  • Stenting is a minimally invasive procedure intended to restore forward blood flow by expanding and propping open the channel within a damaged vein.

Researcher Statements

Suresh Vedantham, M.D., the study's principal investigator, provided commentary on the results.

"The study suggests severe PTS is a treatable condition for many patients."

He stated that while standard treatments like anticoagulation and compression are important, for many patients they are not sufficient to improve leg symptoms and enable normal daily functioning.

He added that the C-TRACT results indicate patients with moderate-to-severe PTS and large vein blockage could benefit from endovascular stent treatment and should consult with an interventional radiologist for evaluation.

Vedantham also observed that many patients with PTS suffer because few physicians are aware of the complication or know how to treat it effectively.