Extension of Iliac Vein Stents into the Inferior Vena Cava Is Not Associated with Increased Incidence of Contralateral DVT

Friday, October 14, 2022

2:31 PM – 2:41 PM US CDT

Location: Celestin D/E (Live Stream)

Presenting Author(s)

Levan Sulakvelidze, BS

Director of Clinical Compliance & Healthcare Delivery
Center for Vascular Medicine
Greenbelt, Maryland

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

PDF Slides

Co-Author(s)

PP

Peter J. Pappas, MD

Regional Medical Director, VLM Program Director
Center For Vein Restoration
Chester, New Jersey

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Richard Kennedy, PA-C

Lakhanpal Vein Foundation
Center for Vascular Medicine
Greenbelt, Maryland

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
GL

Guarav Lakhanpal, MD

Medical Director, Center for Vascular Medicine
Center for Vascular Medicine
Greenbelt, Maryland

Disclosure: Disclosure information not submitted.
Sanjiv Lakhanpal, MD, FACS, DABVLM

President & CEO
Center for Vein Restoration
Greenbelt, Maryland

Disclosure: Disclosure information not submitted.

Co-Author(s)

JP

Jessica N. Pappas

Student
Center For Vein Restoration
Chester Township, New Jersey

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Introduction, Objectives, and/or Purpose: Iliac vein stenting is the standard of care for patients with pelvic venous disorders secondary to symptomatic iliac vein outflow obstruction. Venous stents are often extended proximally into the inferior vena cava (IVC) which may result in partial or complete coverage of the contralateral iliac vein. The purpose of this investigation is to determine if extension of iliac vein stents into the IVC results in increased risk of contralateral deep venous thrombosis (DVT).

Methods: We retrospectively reviewed prospectively collected data from 668 patients who underwent iliac vein stenting at the Center for Vascular Medicine (CVM) from 2019 to 2020. Stent type, covered territories, initial and follow-up consults, ultrasound and operative reports were reviewed to assess for incidence of post-implantation DVT. Patients were stratified into two groups: those who received iliac vein stents which protruded into the IVC and those who received stents which did not protrude into the IVC.

Results: Out of 668 patients, the average age was 53.96±13.40 years with 160 males and 508 females. All stents placed were Venovo stents. The average follow-up period was 14.35 ± 10.09 months. The most common territories stented were the IVC-LCIV-LEIV (n=391, 57%) and the IVC-RCIV-REIV (n=120, 18%). 548 stents protruded into the IVC (82%) while 120 stents did not (18%). The overall DVT rate post-implantation was 4%. The incidence of contralateral DVT in patients with stent protrusion into the IVC was n=2 (0.29%) while the incidence in patients without stent protrusion into the IVC was n=1 (0.15%). There were no significant differences in prevalence of contralateral DVT between the two groups (p=0.49).

Conclusion(s): The rate of contralateral DVTs post iliac vein stenting is low, and partial or complete coverage of the contralateral iliac vein via stent protrusion into the inferior vena cava does not result in increased incidence of contralateral DVT in the short-term. Longer follow up is needed to determine if contralateral DVTs occur after long-term implantation.