{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:47:13Z","timestamp":1789757233024,"version":"4.0.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,2,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Postthrombotic syndrome is a common complication of deep vein thrombosis, with limited treatment options.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              ACCESS PTS (Accelerated Thrombolysis for Post\u2010Thrombotic Syndrome Using the Acoustic Pulse Thrombolysis Ekosonic Endovascular System) is a multicenter, single\u2010arm, prospective study evaluating patients with chronic deep vein thrombosis and postthrombotic syndrome (Villalta score \u22658) who received minimum 3\u00a0months of anticoagulation. Patients underwent percutaneous transluminal venoplasty and ultrasound\u2010accelerated thrombolysis, with data collected on clinical characteristics, postthrombotic syndrome, imaging, and quality of life to 1\u00a0year. The primary efficacy outcome was a reduction of \u22654 points in the Villalta score 30\u00a0days after procedure. The primary safety outcomes were major bleeding episodes within 72\u00a0hours and symptomatic pulmonary embolism during the index hospitalization. A total of 82 limbs (78 patients) were treated (age, 54.6\u00b112.7\u00a0years; 32.1% women; mean Villalta score, 15.5\u00b15.2). The primary end point was met in 64.6% (51\/79). At 1\u00a0year, 77.3% (51\/66) of limbs continued with a Villalta reduction \u22654. At 365\u00a0days, &gt;90% of segments had patency with ultrasound flow present. Baseline to 1\u2010year Physical Component Summary mean score of the Short Form\u201036 increased from 38.9\u00b19.5 to 45.2\u00b19.8 (\n              <jats:italic>P<\/jats:italic>\n              \u22640.0001), and mean\n              <jats:styled-content style=\"fixed-case\">VEINES<\/jats:styled-content>\n              \u2010\n              <jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content>\n              (Venous Insufficiency Epidemiological and Economic Study\u2013Quality of Life) increased from 61.9\u00b119.7 to 82.6\u00b120.8 at 1\u00a0year (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). Iliofemoral venous stenting was performed in 42 patients, with similar improvements seen in all outcomes, regardless of stenting status. One patient developed severe bleeding within 72\u00a0hours of the intervention and died at 32\u00a0days after procedure (1.3% mortality rate).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Percutaneous transluminal venoplasty and ultrasound\u2010accelerated thrombolysis resulted in successful recanalization of chronic venous obstruction with improved postthrombotic syndrome severity and quality of life. Results were sustained at 1\u2010year after procedure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\n              :\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/\">https:\/\/www.clinicaltrials.gov\/<\/jats:ext-link>\n              . Unique identifier:\n              <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n              02159521.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.013398","type":"journal-article","created":{"date-parts":[[2020,1,25]],"date-time":"2020-01-25T10:00:15Z","timestamp":1579946415000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Ultrasound\u2010Accelerated Thrombolysis and Venoplasty for the Treatment of the Postthrombotic Syndrome: Results of the ACCESS PTS Study"],"prefix":"10.1161","volume":"9","author":[{"given":"Mark J.","family":"Garcia","sequence":"first","affiliation":[{"name":"EndoVascular Consultants Wilmington DE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith M.","family":"Sterling","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Interventional Radiology Inova Alexandria Hospital Alexandria VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan R.","family":"Kahn","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine and Center for Clinical Epidemiology Jewish General Hospital Department of Medicine McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Comerota","sequence":"additional","affiliation":[{"name":"Inova Heart and Vascular Institute Inova Alexandria Hospital Alexandria VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Jaff","sequence":"additional","affiliation":[{"name":"Newton\u2010Wellesley Hospital Newton MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Ouriel","sequence":"additional","affiliation":[{"name":"Syntactx New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ido","family":"Weinberg","sequence":"additional","affiliation":[{"name":"VasCore The Vascular Ultrasound Core Laboratory Massachusetts General Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Herman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Leung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Dexter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Gagne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Razdan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Winokur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Dwivedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akhilesh","family":"Sista","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Butler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifford","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Feldtman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Kee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Leon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna","family":"Mannava","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000031167.64088.F6"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-009-0309-3"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2008.03002.x"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2004.04.007"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000103067.10695.74"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(86)90377-0"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1615066"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.037425"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(15)00248-3"},{"key":"e_1_3_2_11_2","first-page":"54","article-title":"Endovascular options for chronic DVT","author":"Garcia MJ","year":"2012","unstructured":"Garcia MJ. Endovascular options for chronic DVT. Endovascular Today. 2012;54\u201358.","journal-title":"Endovascular Today"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61753-4"},{"key":"e_1_3_2_13_2","first-page":"1005","article-title":"Thrombolysis with ultrasound effect","volume":"104","author":"Kudo S","year":"1989","unstructured":"Kudo S. Thrombolysis with ultrasound effect. Tokyo Jikeikai Med J. 1989;104:1005.","journal-title":"Tokyo Jikeikai Med J"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V81.10.2636.2636"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1657688"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4613-1243-7_6"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/152660280100800308"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2011.12.345"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2005.01204.x"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-149-10-200811180-00004"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1677795"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2015.03.029"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2012.06.012"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2015.02.026"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.211.1.r99ap4739"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2017.10.024"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X16650747"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.013398","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:37:31Z","timestamp":1715600251000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.013398"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,4]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,2,4]]}},"alternative-id":["10.1161\/JAHA.119.013398"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.013398","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,4]]},"assertion":[{"value":"2019-05-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e013398"}}