Effectiveness of Venous Stenting for the Treatment of Lower Extremity Chronic Thrombotic Venous Obstruction

• Published in: Annals of vascular surgery Vol. 92; pp. 142 - 148
• Main Authors: Elshinawy, Waleed E., Abdo, Ehab M., Farouk, Nehal, Abdelmohsen, Abdelhalim A., Sakr, Lobna kh, Abdo, Walaa Husein, Ali, Sally Mohamed Osama
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.05.2023
• Subjects: Endovascular Procedures - adverse effects; Endovascular Procedures - methods; Female; Humans; Iliac Vein; Lower Extremity; Middle Aged; Quality of Life; Retrospective Studies; Stents; Thrombosis; Treatment Outcome; Vascular Patency
• ISSN: 0890-5096; 1615-5947
• DOI: 10.1016/j.avsg.2022.12.084

Patients with venous hypertension (HTN) have significant morbidity and poor quality of life. Deep venous thrombosis (DVT) and congenital defects that led to chronic outflow blockage are frequent causes of venous HTN. It is known that the venovenous bypass has been the standard method used in the treatment of chronic iliofemoral vein occlusions. Percutaneous recanalization has earlier been shown to be technically possible. With venoplasty and stenting, we used an aggressive endovascular strategy to treat the iliofemoral venous thrombotic occlusion. From May 2019 to April 2021, the medical records were reviewed for 63 patients diagnosed with symptomatic iliofemoral thrombotic occlusive disease and treated with venous stenting. The procedures' results were analyzed at Al-Azhar University Hospitals. The medical records of 63 cases (44 women with a median age of 49.52 years), with chronic outflow block of iliofemoral vein segment that were treated with endovascular venous stenting, were reviewed retrospectively. Optimal success was obtained in 56 cases (88.9%). The twelve-month primary, assisted primary, and secondary patency rates were 76.8%, 80.4%, and 87.5%, respectively, while it was 73.2%, 80.4%, and 87.5%, respectively, after 2 years. The procedure-related complication rate was 6.3%. Puncture site hematoma was observed in 2 patients (3.2%). Early (30 days) stent thrombosis occurred in 2 patients (3.2%). Most importantly, there was no procedure-related mortality. Endovascular treatment with balloon angioplasty and stenting of chronic venous thrombotic occlusions is an effective and safe procedure associated with a high technical rate of success and excellent patency rates. Accordingly, it should be considered the first line in the treatment of symptomatic iliofemoral vein occlusion.