ABSTRACT
Sina Zarrintan, MD, MS, MPH
Postdoctoral Research Fellow
University of California San Diego
San Diego, California, United States
A total of 21 patients (14 males and 7 females) with median age of 45.6 (36.6, 61.3) were studied. Ten patients (47.6%) had a history of hypercoagulable state. The side of the intervention was bilateral, right side and left side in 13 (61.9%), 2 (9.5%) and 6 patients (28.6%), respectively. The main indication for intervention was severe edema (9 patients, 42.9%) followed by venous claudication (6 patients, 28.6%). The median number of stents used was 3.5 (1, 7). Inferior vena cava was stented in 12 patients (57.1%), whereas common iliac, external iliac and common femoral veins were stented in 18 (85.7%), 15 (71.4%) and 5 (23.8%) patients, respectively. The median length of the stented veins was 258 (100, 355) mm. The median fluoroscopy time was 29.4 (19, 43.3) min. There was one access site hematoma (4.8%) and it was managed without complication. There was no stent migration. There was neither postoperative myocardial infarction nor in-hospital death. One patient had postoperative pulmonary embolism (4.8%) incidentally found. The median postoperative stay was 1 (0, 5) days. The median follow-up was 18.3 (2.7, 43.0) months. Improvement of edema was observed in 13 out of 17 patients (76.5%) in the last follow-up visit, while improvements of pain and venous claudication were observed in 15 out of 20 patients (75.0%) and 15 out of 19 patients (79.0%), respectively. The Duplex illustrated patent stents in 14 out of 17 patients (82.3%) at median of 7.2 (2.3, 23.2) months.
Conclusions:
Iliocaval vein stenting for the chronically occluded veins by the use of covered stents offer potentially improved outcomes in complex long lesions, easier reinterventions if needed with less intimal hyperplasia throughout the length of the stents. Further rigorous comparative assessment is necessary to evaluate advantages of this approach.