{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:12:33Z","timestamp":1787019153037,"version":"build-2736575974"},"reference-count":28,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Med"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In-stent occlusion (ISO) remains a significant challenge in postthrombotic syndrome (PTS), with limited histopathologic characterization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between January 2022 and November 2024, 19 patients with PTS (12 men; mean age 44.3 \u00b1 12.4 years) presenting with 20 iliofemoral venous ISO underwent thrombectomy using the RevCore system. Histopathology was performed on retrieved materials from 16 limbs. Technical success, stent patency, and Villalta score were assessed. Kaplan\u2013Meier and Cox regression identified predictors of restenosis\/occlusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Technical success was 95% (19\/20 limbs). In venous stent occlusions &lt; 3 months duration (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 12), retrieved materials contained more fresh thrombus (40.4%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.058) and old thrombus (41.3%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.040) than in occlusions \u2a7e 3 months duration (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 4), where diffuse intimal thickening (DIT) was predominant (73.8%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.008). Severe restenosis\/occlusion occurred in 60% (12\/20) of limbs during a median 209.5-day follow up, with median patency of 144.5 days. Villalta scores improved from 14.8 \u00b1 7.1 to 9.4 \u00b1 6.8 at 1 month (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002) and 9.5 \u00b1 6.8 at the final follow up (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.001). Retrieved materials containing &gt; 50% old thrombus had a higher restenosis\/occlusion risk (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.026). Common iliac vein (CIV) residual stenosis \u2a7e 30% (hazard ratio (HR) = 4.103;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.037) and a restored common femoral vein (CFV) flow diameter &lt; 8.0 mm (HR = 3.871;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.026) predicted severe restenosis\/occlusion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In PTS-related ISO, DIT predominated in occlusion \u2a7e 3 months. Old thrombus, CIV residual stenosis \u2a7e 30%, and a CFV flow diameter &lt; 8.0 mm predicted restenosis\/occlusion. Integrating histopathologic assessment into postthrombectomy evaluation may help tailor and optimize management strategies for iliofemoral ISO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1358863x251392496","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T10:21:47Z","timestamp":1766053307000},"page":"81-89","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Histopathology of iliofemoral vein in-stent occlusion in postthrombotic syndrome: Findings from endovascular thrombectomy"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5388-0025","authenticated-orcid":false,"given":"Yanqing","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan, Ann Arbor, MI, USA"},{"name":"Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6654-6607","authenticated-orcid":false,"given":"Amber","family":"Liles","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7613-2366","authenticated-orcid":false,"given":"Andrea Tara","family":"Obi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0410-4563","authenticated-orcid":false,"given":"Oscar","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2540-9745","authenticated-orcid":false,"given":"David","family":"Gordon","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2775-7508","authenticated-orcid":false,"given":"William M","family":"Sherk","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5061-6688","authenticated-orcid":false,"given":"Minhaj S","family":"Khaja","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","DOI":"10.1016\/j.jvs.2014.04.049","article-title":"Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery \u00ae and the American Venous Forum","volume":"60","author":"O\u2019Donnell TF","year":"2014","unstructured":"O\u2019Donnell TFJr, Passman MA, Marston WA, et al. 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