Evidence map›Paper›PMID 41972998›Full record

Trial reportThe New England journal of medicine2026

Endovascular Therapy for Post-Thrombotic Syndrome - A Randomized Trial.

Suresh Vedantham, Susan R Kahn, William A Marston, Ido Weinberg, Akhilesh K Sista, Elizabeth A Magnuson, David J Cohen, Suman M Wasan, Mahmood K Razavi, Samuel Z Goldhaber and 31 more

Registry-linked trialAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03250247 (Chronic Venous Thrombosis), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03250247 naactive not recruitingnot on this map

Chronic Venous Thrombosis: Relief With Adjunctive Catheter-Directed Therapy - The C-TRACT Trial

TypeinterventionalSponsorWashington University School of MedicineRan2018 to 2026Enrolled225ConditionsDeep Vein Thrombosis, Venous Stasis, Venous Insufficiency, Venous Leg UlcerArmsStents
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Review
  3. Factors associated with patency loss after iliocaval and iliofemoral venous stenting.Journal of vascular surgery. Venous and lymphatic disorders · 2026
    Review
  4. Stenting for post-thrombotic syndrome.Nature reviews. Cardiology · 2026
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

41 authors.

Suresh VedanthamMallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis.
Susan R KahnMcGill University, Jewish General Hospital, Montreal.ORCID 0000-0002-5667-8916
William A MarstonUniversity of North Carolina School of Medicine, Chapel Hill.
Ido WeinbergMassachusetts General Hospital, Harvard Medical School, Boston.ORCID 0000-0003-4633-5132
Akhilesh K SistaNewYork-Presbyterian-Weill Cornell Medical Center, New York.
Elizabeth A MagnusonSaint Luke's Mid America Heart Institute, University of Missouri-Kansas City School of Medicine, Kansas City.
David J CohenCardiovascular Research Foundation, New York.ORCID 0000-0001-9163-724X
Suman M WasanWake Forest University School of Medicine, Winston-Salem, NC.
Mahmood K RazaviSt. Joseph Heart and Vascular Center, Orange, CA.
Samuel Z GoldhaberBrigham and Women's Hospital, Harvard Medical School, Boston.
Kristen M SanfilippoWashington University School of Medicine, St. Louis.
Anthony J ComerotaInova Alexandria Hospital, Alexandria, VA.
Ezana M AzeneEmplify Health, La Crosse, WI.
Cassius Iyad Ochoa ChaarYale University School of Medicine, New Haven, CT.
Daniel A LeungChristiana Hospital, Newark, DE.
K Pallav KolliUniversity of California, San Francisco, San Francisco.
Sanjeeva P KalvaUniversity of Texas Southwestern Medical Center, Dallas.
Nassir RostambeigiMallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis.
Ajinkya DesaiUniversity of Mississippi Medical Center, Jackson.
Kush R DesaiNorthwestern University, Chicago.
Alfonso J TafurEndeavor Health Evanston Hospital, Evanston, IL.
Bhavraj KhalsaSt. Joseph Heart and Vascular Center, Orange, CA.
Elaine MajerusWashington University School of Medicine, St. Louis.
Borong WangMcMaster University, Hamilton, ON, Canada.
Yang WangMcMaster University, Hamilton, ON, Canada.ORCID 0009-0001-3138-0689
Patricia NietersMallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis.
Mary Clare DerflerMallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis.
Angela OliverMallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis.
Cassandra HardyMallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis.
Riyaz BashirMayo Clinic, Jacksonville, FL.
Ronald WinokurNewYork-Presbyterian-Weill Cornell Medical Center, New York.
Natalie WegerUniversity of Iowa Health Care Medical Center, Iowa City.
Minhaj S KhajaUniversity of Michigan, Ann Arbor.
Aditya SharmaAtrium Health, Charlotte, NC.
Naganathan ManiMallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis.
Pavan KavaliMallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis.ORCID 0000-0002-4195-9037
Siddhant ThukralDuke University Medical Center, Durham, NC.
Leslie L LakeNational Blood Clot Alliance, Philadelphia.
Kathryn MikkelsenVasculearn Network, Boston.
Sameer ParpiaMcMaster University, Hamilton, ON, Canada.
C-TRACT Trial Investigators

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
1/2 CATHETER-DIRECTED THERAPY FOR CHRONIC DVT (C-TRACT TRIAL)UH3HL138325 · NHLBI · WASHINGTON UNIVERSITY · PI VEDANTHAM, SURESH · 2018 to 2023
$8.1M
2/2 Catheter-Directed Therapy for Chronic DVT (C-TRACT Trial)-DCCU24HL137835 · NHLBI · MCMASTER UNIVERSITY · PI PARPIA, SAMEER · 2017 to 2023
$2.1M
1/2 CATHETER-DIRECTED THERAPY FOR CHRONIC DVT (C-TRACT TRIAL)UG3HL138325 · NHLBI · WASHINGTON UNIVERSITY · PI VEDANTHAM, SURESH · 2017 to 2017
$1.4M
CHRONIC VENOUS THROMBOSIS: RELIEF WITH ADJUNCTIVE CATHETER-BASED THERAPY (C-TRACTU34HL123831 · NHLBI · WASHINGTON UNIVERSITY · PI VEDANTHAM, SURESH · 2014 to 2015
$654k
NCATS NIH HHS UL1 TR002345NCATS NIH HHS UL1TR002345NHLBI NIH HHS U24 HL137835NHLBI NIH HHS U24HL137835NHLBI NIH HHS U34 HL123831NHLBI NIH HHS U34HL123831NHLBI NIH HHS UG3 HL138325NHLBI NIH HHS UG3HL138325NHLBI NIH HHS UH3 HL138325NHLBI NIH HHS UH3HL138325
6 · The paper itself

Abstract

backgroundPost-thrombotic syndrome is common after deep-vein thrombosis and can cause severe symptoms involving the limbs that impair patients' activity and quality of life. Endovascular therapy can eliminate chronic venous obstruction and is hypothesized to reduce the severity of post-thrombotic syndrome.

methodsWe randomly assigned 225 patients with moderate or severe post-thrombotic syndrome and imaging-confirmed iliac-vein obstruction to receive endovascular therapy (iliac-vein stent placement and enhanced antithrombotic therapy) plus standard post-thrombotic syndrome care or standard post-thrombotic syndrome care alone. The severity of post-thrombotic syndrome at 6 months (the primary outcome) was assessed with the validated Venous Clinical Severity Score (VCSS) tool (scores range from 0 to 30, with higher scores indicating more severe post-thrombotic syndrome) by evaluators who were unaware of the group assignments. Key secondary outcomes included venous disease-specific and overall quality of life.

resultsAt 6 months, the severity of post-thrombotic syndrome was lower in the endovascular-therapy group than in the no-endovascular-therapy group (mean [±SD] VCSS, 8.1±5.1 vs. 10.0±4.9; adjusted difference, -2.0; P = 0.001). Venous disease-specific quality of life as assessed with the Venous Insufficiency Epidemiological and Economic Study Quality of Life questionnaire was better in the endovascular-therapy group than in the no-endovascular-therapy group at 6 months (adjusted difference, 14.5 points; P<0.001), as was overall quality of life as assessed with the Medical Outcomes Study 36-Item Short-Form Health Status Survey physical component summary score (adjusted difference, 6.1 points; P<0.001); scores on both tools range from 0 to 100. Through 6 months, bleeding was more common in the endovascular-therapy group than in the no-endovascular-therapy group (in 11.6% vs. 3.6% of the patients; P = 0.03).

conclusionsAmong patients with moderate or severe post-thrombotic syndrome and iliac-vein obstruction, endovascular therapy led to less severe post-thrombotic syndrome and better health-related quality of life than standard care over a 6-month period but with a higher risk of bleeding. (Funded by the National Heart, Lung, and Blood Institute and others; C-TRACT ClinicalTrials.gov number, NCT03250247.).

Indexed as

Catheterization, PeripheralFibrinolytic AgentsHemorrhageIliac VeinPostthrombotic SyndromeStentsAdultAgedChronic DiseaseCombined Modality TherapyFemaleHumansMaleMiddle AgedPhlebographyQuality of LifeFibrinolytic Agents

Identifiers

PMID41972998
PMCPMC13078690

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.