14 Apr SIR and NEJM: Endovascular Stenting Improves Outcomes in Post-Thrombotic Syndrome: C-TRACT Trial

Editor’s note: This research was presented at the SIR 2026 Annual Scientific Meeting and simultaneously published in The New England Journal of Medicine.

MedicalResearch.com Interview with:

Prof. Vedantham

Prof. Suresh Vedantham, MD
Professor of Radiology and Surgery
Washington University School of Medicine
St. Louis, Missouri

About 700,000 people experience an episode of deep vein thrombosis (DVT) each year in North America — half new cases, half recurrences. Approximately 40% of new cases lead to long-term symptoms known as post-thrombotic syndrome (PTS), a chronic condition that affects patients’ ability to walk, work, and maintain a normal quality of life. A landmark new randomized trial published in The New England Journal of Medicine now offers new hope for patients suffering from this debilitating condition.

MedicalResearch.com spoke with Principal Investigator Suresh Vedantham, MD, Professor of Radiology and Surgery at Washington University School of Medicine in St. Louis, about the C-TRACT trial findings.

MedicalResearch.com: What is the background for this study? How common is chronic venous thrombosis, and who is primarily affected?

Response: About 700,000 people experience an episode of deep vein thrombosis each year — half new cases, half recurrences — in North America. About 40% of new cases lead to long-term symptoms (post-thrombotic syndrome) that affect patients’ ability to walk, work, and have a normal quality of life.

DVT affects people across the demographic spectrum. Many but not all have identifiable risk factors at the time of their DVT episode: recent surgery, bony fracture, medical illness causing prolonged bedrest, pregnancy, cancer, hormonal factors, or disorders (some inherited) of the blood clotting system.

MedicalResearch.com: Would you describe the catheter-directed therapy? How difficult is the procedure to perform?

Response: It is a minimally invasive treatment performed under imaging guidance, usually delivered on an outpatient basis — most patients do not need to stay in the hospital. The procedure typically requires one or two tiny skin incisions of 3–4 mm, not a large surgical-style incision, and takes 2–3 hours. It is performed by specially trained physicians such as interventional radiologists.

MedicalResearch.com: Is there a time frame in which the procedure achieves better or best results?

Response: Not really — it can be done months to many years after the initial DVT episode.

MedicalResearch.com: What are the main findings?

Response: In patients with post-thrombotic syndrome that causes substantial life interference, and who have blockage of the iliac vein, endovascular stent placement results in improved PTS severity and quality of life.

MedicalResearch.com: What should readers take away from your report?

Response: Patients suffering with PTS have new hope that there is an effective treatment. We hope the findings will spur increased awareness of PTS among health providers to enable more patients to be referred for quality PTS care. Blood thinning drugs are important for DVT patients, but patients’ symptoms and quality of life should also be given due attention.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: We need more research to explore the biology of PTS and to find new ways to get and keep veins open.

MedicalResearch.com: Is there anything else you would like to add? Any disclosures?

Response: The study was funded by NIH alone, with no involvement of stent manufacturers. Medi USA donated compression stockings to study patients. Leading DVT physicians and scientists from different specialties were involved, along with study teams in 29 U.S. clinical centers. Thanks very much for your interest in this study.

Citation

Endovascular Therapy for Post-Thrombotic Syndrome — A Randomized Trial

Suresh Vedantham, M.D., Susan R. Kahn, M.D., William A. Marston, M.D., Ido Weinberg, M.D., Akhilesh K. Sista, M.D., Elizabeth A. Magnuson, Sc.D., David J. Cohen, M.D., et al., for the C-TRACT Trial Investigators

The New England Journal of Medicine. Published April 13, 2026. DOI: 10.1056/NEJMoa2519001

Presented at the SIR 2026 Annual Scientific Meeting.

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Last Updated on April 14, 2026 by Marie Benz MD FAAD