Stenting of the venous outflow in chronic venous disease: Long-term stent-related outcome, clinical, and hemodynamic result

Abstract

Venous stenting can be performed with low morbidity and mortality, long-term high patency rate, and a low rate of in-stent restenosis. It resulted in major symptom relief in patients with chronic venous disease, which was not consistently reflected in any substantial hemodynamic improvement by conventional measurements. The beneficial clinical outcome occurred regardless of presence of remaining reflux, adjunct saphenous procedures, or etiology of obstruction.

CIRSE Standards of Practice Guidelines on Iliocaval Stenting

“…In a series by Hartung et al, all but 2 of 47 (96 %) ulcers healed after venous stenting [53]. Neglén et al reported a longterm ulcer healing rate of 55 % [49]. These clinical results were proven by several recent studies, which reported significant decrease in the VCSS after stenting of iliocaval obstructions [54] or reduced swelling and pain levels after endovenous treatment [47,55].…”

“…Two major series from different groups on stenting in postthrombotic iliac vein obstruction report primary, assisted primary and secondary patency rates of 57, 80, and 86 % at 6 years [49] and 83, 89, and 93 % at 10 years, respectively [50]. A detailed analysis of the outcome of stenting in postthrombotic iliocaval obstruction can be found in a recently published review [51].…”

“…A detailed analysis of the outcome of stenting in postthrombotic iliocaval obstruction can be found in a recently published review [51]. In patients with primary iliac vein obstruction, long-term results are even better with primary, assisted primary, and secondary patency rates of 79, 100, and 100 % at 6 years [49]. Titus et al also stress the significance of underlying disease for long-term results, as they report a significantly better 2-year outcome in patients with May-Thurner syndrome when compared with external compression or thrombophilia as underlying cause of disease [52].…”

“…The mortality rate after endovenous revascularization is low with mortality rates ranging from 0-1 % [49,57]. The most common complications are early (\30 days) and late rethrombosis with 1.5-3 % for early and roughly 5 % for late events [49,58].…”

“…The most common complications are early (\30 days) and late rethrombosis with 1.5-3 % for early and roughly 5 % for late events [49,58]. Extension of the stent into the IVC is associated with contralateral iliac vein occlusion in approximately 1 % of patients [49].…”