Stent placement on fresh venous thrombosis

• Published in: Cardiovascular and interventional radiology Vol. 20; no. 5; pp. 359 - 363
• Main Authors: VORWERK, D, GUENTHER, R. W, SCHÜRMANN, K
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.09.1997; Berlin
• Subjects: Aged; Arteriovenous Shunt, Surgical; Biological and medical sciences; Brachiocephalic Veins; BYPASSES; DIALYSIS; Female; Follow-Up Studies; Graft Occlusion, Vascular - diagnostic imaging; Graft Occlusion, Vascular - therapy; GRAFTS; Humans; Iliac Vein; Male; Medical sciences; PATIENTS; Radiography; RADIOLOGY AND NUCLEAR MEDICINE; Recurrence; Renal Dialysis; Stents; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; SWELLING; THROMBOSIS; Thrombosis - diagnostic imaging; Thrombosis - therapy; Time Factors; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; VEINS; Human; Endoprosthesis; Radiodiagnosis; Angiography; Acute; Cardiovascular disease; Stent; Thrombosis; Venous disease; Vascular disease; Treatment; Surveillance; Surgery; Technique; Vein
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s002709900168

To report on the efficacy of fixing fresh venous thrombus to the venous wall by stent placement. Seven patients underwent stenting to treat acute venous thrombosis. In two patients, the hemodialysis fistula was thrombosed with the thrombus extending into the brachial veins. In three patients, the hemodialysis fistula was patent but massive swelling of the ipsilateral arm was caused by proximal venous thrombosis. Two patients presented with iliac venous thrombosis within stented pelvic veins. Stent placement was preceded by other mechanical thrombectomy methods in all cases. Attachment of thrombus to the venous wall was successful in all cases treated. Acute rethrombosis did not occur. Follow-up patency in dialysis patients was 7.2 +/- 2.1 months. One patient had rethrombosis of the dialysis graft 3 months after primary treatment. Three patients developed restenosis within a mean period of 7.7 months. One shunt remained patent for 10 months with no event of reobstruction during follow-up. In both patients with iliac stent placement, the vein remained patent over a follow-up period of 8 and 12 months respectively. Stenting fresh venous thrombus can achieve immediate venous patency. It may be used as an alternative approach when all other percutaneous methods fail. Frequent restenosis within stented veins limits its use to very selected cases.