Angioplasty-stenting vs Optimal Medical Treatment on Post-thrombotic Syndrome Reduction

Inclusion Criteria: * Patient age ≥ 18 years' old * Patient with disabling PTS defined as a Villalta score ≥ 10, more than 6 months after unilateral proximal deep vein thrombosis (first or recurrent episode) involving at least iliac vein. A contralateral distal or superficial vein thrombosis was not considered as bilateral thrombosis. Rational for main inclusion criteria: Patients would be screened more than 6 months after the index DVT event to be sure that symptoms were related to chronic phase of PTS and not to the acute DVT event. Although endovascular therapy has actually matured to propose a systematic evaluation, the procedure remains experimental with potential risks. Therefore, the study must focus on patients with advanced PTS and iliofemoral obstruction, since this population appears to have the greatest attempted benefit. Exclusion Criteria: * Index DVT without iliac thrombosis * Bilateral proximal deep vein thrombosis or Inferior vena cava thrombosis * Lower limb arteriopathy defined as ante-brachial index \< 0.5 * Vena cava filter * Venous ulcers ≥ 50 cm² * Life expectancy \< 6 months * Contraindication to anticoagulant treatment by direct oral anticoagulant * Contraindication to the use of low-dose aspirin (100 mg) * Use of dual antiplatelet agents aspirin/clopidogrel * Use of Prasugrel or Ticagrelor * Previous venous recanalization of the same leg * Impossible to follow-up * Contraindication to contrast iodine * Renal insufficiency (Cockroft \<30 ml/min,…